| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.15 | $151.15 | $151.15 | |
Aetna
| Professional | $141.52 | $151.15 | $183.71 | |
Cigna
| Professional | $141.06 | $141.06 | $141.06 | |
Kaiser Permanente
| Professional | $109.12 | $134.30 | $351.17 | |
United
| Professional | $161.44 | $362.85 | $412.80 |