| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $104.71 | $181.97 | |
Aetna
| Professional | $91.20 | $100.00 | $123.03 | |
Cigna
| Facility | $114.82 | $114.82 | $114.82 | |
Kaiser Permanente
| Professional | $125.89 | $125.89 | $125.89 | |
United
| Professional | $100.00 | $114.82 | $147.91 |