| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.56 | $151.56 | $151.56 | |
Aetna
| Professional | $129.16 | $151.56 | $151.56 | |
Cigna
| Professional | $147.91 | $147.91 | $147.91 | |
Kaiser Permanente
| Professional | $388.27 | $408.70 | $510.88 | |
United
| Professional | $342.87 | $342.87 | $555.72 |