| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.96 | $245.96 | $328.00 | |
Aetna
| Professional | $30.00 | $41.00 | $476.00 | |
Cigna
| Professional | $150.00 | $216.00 | $282.63 | |
Kaiser Permanente
| Professional | $180.00 | $260.00 | $332.00 | |
United
| Professional | $45.00 | $60.00 | $92.71 | |
Wellpoint
| Professional | $68.92 | $68.92 | $100.00 |