| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.29 | $23.99 | |
Cigna
| Professional | $1.12 | $1.12 | $1.12 | |
Kaiser Permanente
| Professional | $1.35 | $1.62 | $2.57 | |
United
| Facility | $234.42 | $234.42 | $234.42 | |
United
| Professional | $234.42 | $234.42 | $239.88 | |
Wellpoint
| Professional | $234.42 | $234.42 | $234.42 |