| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $75.79 | $75.79 | $76.55 | |
Cigna
| Professional | $75.79 | $143.31 | $143.31 | |
HMSA
| Professional | $156.93 | $174.37 | $200.53 | |
Kaiser Permanente
| Professional | $83.37 | $90.95 | $106.11 | |
United
| Professional | $75.79 | $113.69 | $143.31 |