| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.43 | $50.43 | $50.43 | |
Aetna
| Professional | $30.88 | $50.43 | $60.96 | |
Cigna
| Professional | $43.15 | $43.15 | $43.15 | |
Kaiser Permanente
| Professional | $33.47 | $41.21 | $107.73 | |
United
| Professional | $43.31 | $67.51 | $127.20 |