| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.05 | $60.05 | $60.05 | |
Aetna
| Professional | $30.10 | $60.05 | $82.87 | |
Cigna
| Professional | $54.32 | $87.32 | $196.82 | |
Kaiser Permanente
| Professional | $149.56 | $232.54 | $310.64 |