| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.54 | $25.47 | $36.64 | |
Cigna
| Facility | $54.84 | $54.84 | $54.84 | |
Cigna
| Professional | $36.29 | $36.29 | $63.82 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Professional | $17.57 | $28.58 | $87.03 |