| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $186.21 | $186.21 | $186.21 | |
Aetna
| Professional | $186.21 | $186.21 | $269.15 | |
Cigna
| Facility | $204.17 | $204.17 | $204.17 | |
Kaiser Permanente
| Professional | $245.47 | $245.47 | $245.47 | |
United
| Professional | $173.78 | $204.17 | $263.03 |