| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $144.16 | $151.27 | $151.27 | |
Cigna
| Facility | $151.27 | $151.27 | $151.27 | |
Cigna
| Professional | $151.27 | $151.27 | $151.27 | |
Kaiser Permanente
| Professional | $96.94 | $123.11 | $145.41 | |
United
| Professional | $161.79 | $161.79 | $171.50 |