| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.55 | $51.55 | $51.55 | |
Aetna
| Professional | $30.49 | $51.55 | $60.96 | |
Cigna
| Professional | $44.04 | $44.04 | $44.04 | |
Kaiser Permanente
| Professional | $34.20 | $42.10 | $110.07 | |
United
| Professional | $50.83 | $116.19 | $127.08 |