| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.89 | $20.89 | $173.78 | |
Aetna
| Professional | $20.89 | $21.88 | $23.99 | |
Cigna
| Facility | $45.71 | $47.86 | $107.15 | |
Cigna
| Professional | $29.51 | $29.51 | $36.31 | |
Kaiser Permanente
| Professional | $54.95 | $54.95 | $54.95 | |
United
| Facility | $33.88 | $33.88 | $33.88 | |
United
| Professional | $11.75 | $16.98 | $43.65 |