| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $154.88 | $186.21 | |
Aetna
| Professional | $85.11 | $134.90 | $194.98 | |
Cigna
| Professional | $186.21 | $186.21 | $186.21 | |
HMSA
| Professional | $158.49 | $186.21 | $194.98 | |
Kaiser Permanente
| Professional | $173.78 | $186.21 | $234.42 | |
United
| Professional | $77.62 | $158.49 | $234.42 |