| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.00 | $53.00 | $53.53 | |
Cigna
| Professional | $53.00 | $92.36 | $115.46 | |
HMSA
| Professional | $97.77 | $112.38 | $129.24 | |
Kaiser Permanente
| Professional | $58.30 | $63.60 | $74.20 | |
United
| Professional | $53.00 | $79.50 | $92.36 |