| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $222.86 | $222.86 | $222.86 | |
Aetna
| Professional | $143.34 | $222.86 | $222.86 | |
Cigna
| Facility | $306.00 | $306.00 | $306.00 | |
Cigna
| Professional | $306.00 | $306.00 | $306.00 | |
Kaiser Permanente
| Professional | $296.69 | $642.64 | $642.64 | |
United
| Professional | $300.00 | $300.00 | $486.23 |