| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.33 | $55.33 | $55.33 | |
Aetna
| Professional | $50.48 | $55.33 | $55.33 | |
Cigna
| Professional | $64.00 | $64.00 | $76.68 | |
Kaiser Permanente
| Professional | $49.19 | $58.73 | $120.86 | |
United
| Professional | $37.53 | $56.27 | $124.06 |