| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $40.00 | $84.00 | $115.00 | |
Cigna
| Facility | $51.82 | $51.82 | $51.82 | |
Cigna
| Professional | $38.22 | $38.22 | $38.22 | |
Kaiser Permanente
| Professional | $45.55 | $58.16 | $85.73 | |
United
| Professional | $36.40 | $50.96 | $91.44 | |
Wellpoint
| Professional | $22.38 | $22.38 | $22.38 |