| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.79 | $70.79 | $70.79 | |
Aetna
| Professional | $69.18 | $70.79 | $97.72 | |
Cigna
| Facility | $60.26 | $60.26 | $60.26 | |
Kaiser Permanente
| Professional | $67.61 | $67.61 | $67.61 | |
United
| Professional | $70.79 | $70.79 | $114.82 |