| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.58 | $13.58 | $13.58 | |
Aetna
| Professional | $12.78 | $13.26 | $13.58 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $13.58 | $13.58 | $13.58 | |
Kaiser Permanente
| Professional | $3.08 | $4.01 | $6.05 | |
United
| Professional | $1.99 | $2.58 | $4.23 |