| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $102.68 | $114.72 | $122.74 | |
Cigna
| Professional | $128.30 | $128.30 | $128.30 | |
Kaiser Permanente
| Professional | $17.38 | $25.40 | $250.88 | |
United
| Professional | $90.99 | $118.31 | $263.27 |