| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.89 | $79.84 | $127.09 | |
Cigna
| Facility | $641.21 | $641.21 | $641.21 | |
Kaiser Permanente
| Professional | $167.00 | $176.00 | $189.00 | |
United
| Facility | $36.00 | $36.00 | $41.00 |