| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.45 | $307.45 | $410.00 | |
Aetna
| Professional | $30.00 | $38.00 | $595.00 | |
Cigna
| Professional | $200.00 | $288.00 | $376.84 | |
Kaiser Permanente
| Professional | $225.00 | $325.00 | $415.00 | |
United
| Professional | $46.00 | $60.00 | $92.70 | |
Wellpoint
| Professional | $86.15 | $86.15 | $125.00 |