| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $945.00 | $999.00 | |
Aetna
| Professional | $30.00 | $30.00 | $720.00 | |
Cigna
| Professional | $368.00 | $640.24 | $798.96 | |
Kaiser Permanente
| Professional | $633.69 | $633.69 | $684.00 | |
United
| Professional | $46.00 | $71.54 | $111.59 |