| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $175.90 | $175.90 | $175.90 | |
Aetna
| Professional | $158.61 | $175.90 | $175.90 | |
Cigna
| Facility | $418.44 | $476.38 | $729.07 | |
Kaiser Permanente
| Professional | $36.84 | $79.80 | $79.80 | |
United
| Professional | $105.47 | $144.62 | $405.29 |