| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.87 | $26.87 | $26.87 | |
Aetna
| Professional | $23.25 | $26.87 | $27.91 | |
Cigna
| Professional | $44.04 | $44.04 | $44.04 | |
Kaiser Permanente
| Professional | $23.90 | $41.20 | $114.89 | |
United
| Professional | $22.52 | $50.76 | $121.28 |