| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.61 | $67.61 | $67.61 | |
Aetna
| Professional | $67.61 | $67.61 | $79.43 | |
Cigna
| Facility | $74.13 | $74.13 | $74.13 | |
Kaiser Permanente
| Professional | $34.67 | $34.67 | $34.67 | |
United
| Professional | $63.10 | $74.13 | $95.50 |