| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.80 | $69.80 | $69.80 | |
Aetna
| Professional | $57.78 | $69.80 | $78.88 | |
Cigna
| Professional | $46.91 | $46.91 | $56.20 | |
Kaiser Permanente
| Professional | $81.54 | $99.66 | $126.44 | |
United
| Professional | $59.77 | $74.70 | $138.59 |