| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $525.00 | $555.00 | |
Aetna
| Professional | $30.00 | $30.00 | $400.00 | |
Cigna
| Professional | $184.00 | $320.12 | $399.48 | |
Kaiser Permanente
| Professional | $352.05 | $352.05 | $380.00 | |
United
| Professional | $46.00 | $71.54 | $111.59 |