| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.61 | $158.61 | $158.61 | |
Aetna
| Professional | $119.80 | $175.90 | $182.18 | |
Cigna
| Professional | $31.02 | $31.02 | $33.79 | |
Kaiser Permanente
| Professional | $33.79 | $41.88 | $79.80 | |
United
| Professional | $105.47 | $160.22 | $240.89 |