| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $81.28 | $81.28 | $81.28 | |
Aetna
| Professional | $67.61 | $81.28 | $107.15 | |
Cigna
| Professional | $60.26 | $89.13 | $154.88 | |
Kaiser Permanente
| Professional | $63.10 | $89.13 | $112.20 | |
United
| Facility | $30.20 | $107.15 | $154.88 | |
United
| Professional | $67.61 | $97.72 | $165.96 |