| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.45 | $80.45 | $80.45 | |
Aetna
| Professional | $44.72 | $80.45 | $85.30 | |
Cigna
| Professional | $66.06 | $66.06 | $66.06 | |
Kaiser Permanente
| Professional | $52.04 | $64.05 | $167.47 | |
United
| Professional | $69.31 | $154.91 | $177.86 |