| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $136.41 | $150.41 | $150.41 | |
Cigna
| Professional | $135.10 | $135.10 | $135.10 | |
Kaiser Permanente
| Professional | $166.29 | $372.61 | $372.61 | |
United
| Professional | $141.47 | $528.28 | $528.28 |