| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.38 | $45.38 | $83.68 | |
Aetna
| Professional | $26.14 | $45.38 | $83.68 | |
Cigna
| Professional | $50.29 | $50.29 | $50.29 | |
Kaiser Permanente
| Professional | $26.73 | $45.88 | $165.81 | |
United
| Professional | $46.02 | $101.75 | $209.97 |