| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.04 | $23.04 | $23.04 | |
Cigna
| Professional | $47.49 | $47.49 | $47.49 | |
HMSA
| Professional | $77.50 | $77.50 | $77.50 | |
Kaiser Permanente
| Professional | $58.38 | $63.69 | $74.31 | |
United
| Professional | $53.08 | $63.69 | $79.62 |