| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $33.35 | $47.25 | $73.11 | |
Cigna
| Facility | $52.91 | $52.91 | $52.91 | |
Cigna
| Professional | $57.14 | $57.14 | $57.14 | |
Kaiser Permanente
| Professional | $53.26 | $75.77 | $109.34 | |
United
| Professional | $44.12 | $65.28 | $108.08 | |
Wellpoint
| Professional | $70.16 | $84.96 | $94.40 |