| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.18 | $69.18 | $69.18 | |
Aetna
| Professional | $57.54 | $69.18 | $83.18 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
Kaiser Permanente
| Professional | $52.48 | $61.66 | $162.18 | |
United
| Professional | $60.26 | $93.33 | $173.78 |