| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.29 | $97.12 | $194.25 | |
Aetna
| Professional | $54.86 | $85.29 | $85.29 | |
Cigna
| Facility | $80.29 | $80.29 | $80.29 | |
Cigna
| Professional | $80.29 | $80.29 | $80.29 | |
Kaiser Permanente
| Professional | $106.96 | $231.67 | $231.67 | |
United
| Professional | $28.07 | $51.47 | $103.96 |