| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $185.77 | $185.77 | $185.77 | |
Aetna
| Professional | $89.16 | $185.77 | $185.77 | |
Cigna
| Facility | $183.96 | $183.96 | $183.96 | |
Cigna
| Professional | $183.96 | $183.96 | $183.96 | |
Kaiser Permanente
| Professional | $245.05 | $257.95 | $504.60 | |
United
| Professional | $215.05 | $215.05 | $348.55 |