| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.18 | $83.18 | $83.18 | |
Aetna
| Professional | $83.18 | $85.11 | $213.80 | |
Cigna
| Facility | $95.50 | $95.50 | $95.50 | |
Kaiser Permanente
| Professional | $194.98 | $194.98 | $194.98 | |
United
| Professional | $81.28 | $95.50 | $158.49 |