| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.69 | $59.97 | $102.55 | |
Cigna
| Facility | $139.08 | $139.08 | $139.08 | |
Cigna
| Professional | $101.53 | $101.53 | $101.53 | |
Kaiser Permanente
| Professional | $106.39 | $130.71 | $181.59 | |
United
| Professional | $64.48 | $89.63 | $143.15 | |
Wellpoint
| Professional | $82.47 | $162.57 | $162.57 |