| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $83.18 | $109.65 | $151.36 | |
Cigna
| Professional | $93.33 | $117.49 | $141.25 | |
Kaiser Permanente
| Professional | $109.65 | $138.04 | $181.97 | |
United
| Facility | $120.23 | $120.23 | $120.23 | |
United
| Professional | $91.20 | $128.82 | $199.53 | |
Wellpoint
| Professional | $128.82 | $144.54 | $208.93 |