| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.29 | $70.79 | $97.72 | |
Cigna
| Professional | $56.23 | $77.62 | $100.00 | |
Kaiser Permanente
| Professional | $64.57 | $81.28 | $109.65 | |
United
| Facility | $81.28 | $81.28 | $81.28 | |
United
| Professional | $58.88 | $83.18 | $120.23 | |
Wellpoint
| Professional | $79.43 | $85.11 | $125.89 |