| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $43.26 | $43.26 | $43.26 | |
Aetna
| Professional | $41.34 | $43.26 | $43.26 | |
Cigna
| Professional | $38.69 | $38.69 | $38.69 | |
Kaiser Permanente
| Professional | $45.94 | $92.87 | $92.87 | |
United
| Professional | $32.34 | $40.11 | $117.61 |