| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $203.46 | $203.46 | $203.46 | |
Aetna
| Professional | $192.55 | $223.25 | $275.00 | |
Cigna
| Facility | $137.38 | $137.38 | $137.38 | |
Kaiser Permanente
| Professional | $197.31 | $238.84 | $311.54 | |
United
| Professional | $130.71 | $234.99 | $429.43 |