| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.72 | $101.72 | $102.73 | |
Cigna
| Professional | $101.72 | $122.17 | $140.02 | |
HMSA
| Professional | $160.54 | $178.38 | $205.14 | |
Kaiser Permanente
| Professional | $111.89 | $122.06 | $142.40 | |
United
| Professional | $101.72 | $126.02 | $152.58 |