| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.38 | $182.38 | $182.38 | |
Aetna
| Professional | $137.76 | $182.54 | $205.37 | |
Cigna
| Professional | $27.71 | $32.81 | $46.59 | |
Kaiser Permanente
| Professional | $34.45 | $41.43 | $77.51 | |
United
| Facility | $120.53 | $318.50 | $318.50 | |
United
| Professional | $137.60 | $187.43 | $279.63 |