| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.20 | $21.20 | $173.01 | |
Aetna
| Professional | $21.20 | $21.20 | $21.20 | |
Cigna
| Facility | $45.95 | $47.79 | $102.37 | |
Cigna
| Professional | $29.25 | $29.25 | $36.56 | |
Kaiser Permanente
| Professional | $57.46 | $57.46 | $57.46 | |
United
| Professional | $14.66 | $19.04 | $25.73 |