| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.92 | $15.92 | $15.92 | |
Aetna
| Professional | $15.92 | $15.92 | $15.92 | |
Cigna
| Professional | $40.11 | $40.11 | $40.11 | |
Kaiser Permanente
| Professional | $22.56 | $22.56 | $71.41 | |
United
| Professional | $14.23 | $23.80 | $35.75 |