| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.32 | $20.32 | $20.32 | |
Aetna
| Professional | $20.32 | $20.32 | $35.72 | |
Cigna
| Professional | $22.40 | $22.40 | $22.40 | |
Kaiser Permanente
| Professional | $15.60 | $18.64 | $43.42 | |
United
| Professional | $32.33 | $55.52 | $83.61 |