| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.46 | $103.46 | $1,340.00 | |
Aetna
| Professional | $103.46 | $180.00 | $180.00 | |
Cigna
| Professional | $78.91 | $78.91 | $360.05 | |
Kaiser Permanente
| Professional | $105.13 | $240.39 | $240.39 | |
United
| Professional | $110.99 | $268.97 | $556.73 |