| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.54 | $66.07 | $81.28 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
Kaiser Permanente
| Professional | $52.48 | $77.62 | $100.00 | |
United
| Facility | $77.62 | $85.11 | $117.49 | |
United
| Professional | $58.88 | $87.10 | $144.54 | |
Wellpoint
| Professional | $77.62 | $107.15 | $117.49 |