| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.65 | $76.65 | $76.65 | |
Aetna
| Professional | $65.33 | $76.65 | $76.65 | |
Cigna
| Facility | $93.13 | $93.13 | $93.13 | |
Cigna
| Professional | $93.13 | $93.13 | $93.13 | |
Kaiser Permanente
| Professional | $102.56 | $112.65 | $112.65 | |
United
| Professional | $91.30 | $91.30 | $147.97 |