| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.36 | $213.36 | $213.36 | |
Aetna
| Professional | $213.36 | $213.36 | $213.36 | |
Cigna
| Professional | $218.40 | $223.42 | $649.72 | |
Kaiser Permanente
| Professional | $495.59 | $495.59 | $495.59 | |
United
| Professional | $206.00 | $351.92 | $656.62 |