| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $131.83 | $147.91 | $190.55 | |
Cigna
| Professional | $141.25 | $141.25 | $141.25 | |
Kaiser Permanente
| Professional | $114.82 | $169.82 | $218.78 | |
United
| Facility | $165.96 | $181.97 | $257.04 | |
United
| Professional | $134.90 | $204.17 | $331.13 | |
Wellpoint
| Professional | $169.82 | $234.42 | $257.04 |