| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.00 | $69.00 | $69.00 | |
Aetna
| Professional | $61.85 | $69.00 | $80.41 | |
Cigna
| Professional | $65.77 | $65.77 | $65.77 | |
Kaiser Permanente
| Professional | $51.04 | $62.82 | $163.43 | |
United
| Professional | $70.39 | $93.70 | $176.22 |