| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.64 | $73.64 | $73.64 | |
Aetna
| Professional | $73.64 | $73.64 | $73.64 | |
Cigna
| Facility | $49.22 | $49.22 | $49.22 | |
Kaiser Permanente
| Professional | $44.86 | $44.86 | $142.02 | |
United
| Professional | $14.76 | $16.22 | $16.22 |