| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.10 | $36.10 | $36.10 | |
Aetna
| Professional | $21.28 | $28.60 | $36.10 | |
Cigna
| Professional | $18.97 | $18.97 | $18.97 | |
Kaiser Permanente
| Professional | $17.29 | $21.28 | $54.74 | |
United
| Professional | $18.75 | $63.99 | $64.34 |