| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.43 | $72.43 | $72.43 | |
Aetna
| Professional | $62.39 | $72.43 | $72.43 | |
Cigna
| Professional | $93.02 | $93.02 | $111.44 | |
Kaiser Permanente
| Professional | $73.16 | $87.26 | $149.12 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 | |
United
| Professional | $41.03 | $65.17 | $138.93 |