| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.13 | $46.13 | $46.13 | |
Aetna
| Professional | $42.57 | $46.13 | $55.82 | |
Cigna
| Professional | $44.04 | $44.04 | $44.04 | |
Kaiser Permanente
| Professional | $34.20 | $42.10 | $110.07 | |
United
| Professional | $49.09 | $110.28 | $123.38 |