| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Cigna
| Facility | $12.60 | $12.60 | $12.60 | |
Cigna
| Professional | $12.60 | $12.60 | $19.43 | |
HMSA
| Professional | $18.10 | $18.10 | $18.10 | |
Kaiser Permanente
| Professional | $18.82 | $18.82 | $18.82 | |
United
| Professional | $12.40 | $16.52 | $22.08 |