| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.61 | $67.61 | $67.61 | |
Aetna
| Professional | $27.54 | $67.61 | $67.61 | |
Cigna
| Facility | $67.61 | $67.61 | $67.61 | |
Kaiser Permanente
| Professional | $177.83 | $177.83 | $177.83 | |
United
| Professional | $66.07 | $275.42 | $331.13 |