| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $123.03 | $162.18 | |
Aetna
| Professional | $30.20 | $79.43 | $190.55 | |
Cigna
| Professional | $53.70 | $70.79 | $93.33 | |
Kaiser Permanente
| Professional | $72.44 | $72.44 | $72.44 | |
United
| Professional | $17.38 | $17.38 | $17.38 |