| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $68.48 | $68.48 | $69.17 | |
Cigna
| Professional | $68.48 | $82.18 | $82.18 | |
HMSA
| Professional | $87.00 | $100.00 | $115.00 | |
Kaiser Permanente
| Professional | $75.34 | $82.18 | $95.88 | |
United
| Professional | $68.48 | $82.18 | $102.74 |