| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $152.86 | $152.86 | $152.86 | |
Aetna
| Professional | $104.71 | $152.86 | $365.75 | |
Cigna
| Professional | $50.09 | $60.01 | $81.23 | |
Kaiser Permanente
| Professional | $81.31 | $97.75 | $189.26 | |
United
| Professional | $281.20 | $372.63 | $593.59 |