| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $62.92 | $102.68 | $123.03 | |
Cigna
| Professional | $109.06 | $109.06 | $109.06 | |
Kaiser Permanente
| Professional | $66.34 | $91.07 | $112.85 | |
United
| Professional | $109.96 | $179.21 | $180.60 |