| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.58 | $13.58 | $13.58 | |
Aetna
| Professional | $12.78 | $13.58 | $13.58 | |
Cigna
| Professional | $4.76 | $13.58 | $13.58 | |
Kaiser Permanente
| Professional | $3.28 | $3.86 | $7.93 | |
United
| Professional | $1.99 | $2.65 | $3.91 |