| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.99 | $45.99 | $45.99 | |
Aetna
| Professional | $45.99 | $45.99 | $45.99 | |
Cigna
| Professional | $50.99 | $50.99 | $50.99 | |
Kaiser Permanente
| Professional | $65.16 | $65.16 | $206.28 | |
United
| Professional | $41.10 | $68.73 | $110.85 |