| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $75.86 | $151.36 | |
Aetna
| Professional | $30.20 | $32.36 | $54.95 | |
Cigna
| Facility | $35.48 | $35.48 | $35.48 | |
Kaiser Permanente
| Professional | $47.86 | $47.86 | $47.86 | |
United
| Professional | $30.20 | $35.48 | $44.67 |