| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.98 | $48.98 | $48.98 | |
Aetna
| Professional | $41.69 | $48.98 | $50.12 | |
Cigna
| Facility | $50.12 | $50.12 | $50.12 | |
Kaiser Permanente
| Professional | $67.61 | $67.61 | $67.61 | |
United
| Facility | $50.12 | $50.12 | $50.12 | |
United
| Professional | $48.98 | $48.98 | $79.43 |