| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.31 | $22.31 | $22.31 | |
Aetna
| Professional | $21.79 | $22.31 | $28.56 | |
Cigna
| Professional | $174.33 | $174.33 | $174.33 | |
Kaiser Permanente
| Professional | $210.02 | $256.67 | $480.73 | |
United
| Professional | $137.29 | $167.62 | $282.45 |