| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.97 | $106.97 | $108.04 | |
Cigna
| Professional | $38.74 | $45.58 | $106.97 | |
HMSA
| Professional | $49.91 | $55.45 | $63.77 | |
Kaiser Permanente
| Professional | $117.66 | $128.36 | $149.76 | |
United
| Professional | $38.74 | $96.27 | $160.46 |