| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.56 | $38.56 | $38.56 | |
Aetna
| Professional | $24.80 | $38.56 | $38.56 | |
Cigna
| Professional | $36.29 | $36.29 | $63.82 | |
Kaiser Permanente
| Professional | $43.27 | $50.90 | $104.72 | |
United
| Professional | $27.21 | $34.78 | $50.04 |