| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.04 | $138.04 | $138.04 | |
Aetna
| Professional | $131.83 | $138.04 | $346.74 | |
Cigna
| Facility | $138.04 | $138.04 | $138.04 | |
Kaiser Permanente
| Professional | $251.19 | $251.19 | $251.19 | |
United
| Professional | $331.13 | $331.13 | $537.03 |