| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.48 | $17.48 | $17.48 | |
Aetna
| Professional | $15.66 | $17.48 | $17.48 | |
Cigna
| Professional | $25.30 | $25.30 | $25.30 | |
Kaiser Permanente
| Professional | $16.26 | $19.20 | $35.92 | |
United
| Professional | $13.45 | $23.33 | $54.61 |