| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $239.88 | $323.59 | |
Aetna
| Professional | $74.13 | $87.10 | $93.33 | |
Cigna
| Professional | $87.10 | $87.10 | $131.83 | |
Kaiser Permanente
| Professional | $676.08 | $676.08 | $676.08 |