| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $65.04 | $103.45 | $130.82 | |
Cigna
| Facility | $118.31 | $118.31 | $118.31 | |
Cigna
| Professional | $92.85 | $92.85 | $92.85 | |
Kaiser Permanente
| Professional | $95.75 | $122.03 | $175.18 | |
United
| Professional | $85.22 | $114.33 | $184.16 | |
Wellpoint
| Professional | $112.37 | $137.90 | $153.22 |