| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.00 | $10.00 | $10.00 | |
Aetna
| Professional | $8.91 | $10.00 | $50.12 | |
Cigna
| Facility | $10.23 | $10.23 | $10.23 | |
Kaiser Permanente
| Professional | $47.86 | $47.86 | $47.86 | |
United
| Facility | $3.55 | $3.55 | $3.55 | |
United
| Professional | $10.00 | $10.00 | $16.22 |