| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.00 | $2.00 | $2.00 | |
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Cigna
| Professional | $13.99 | $13.99 | $77.15 | |
Kaiser Permanente
| Professional | $29.00 | $29.00 | $29.00 | |
United
| Professional | $29.24 | $42.83 | $58.80 |