| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.18 | $45.99 | $83.50 | |
Cigna
| Facility | $69.84 | $69.84 | $69.84 | |
Cigna
| Professional | $50.99 | $50.99 | $69.84 | |
Kaiser Permanente
| Professional | $81.59 | $100.25 | $139.27 | |
United
| Professional | $53.96 | $68.73 | $110.85 | |
Wellpoint
| Professional | $82.15 | $82.15 | $91.35 |