| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.50 | $11.50 | $11.50 | |
Aetna
| Professional | $11.50 | $11.50 | $11.50 | |
Cigna
| Professional | $20.51 | $20.51 | $20.51 | |
Kaiser Permanente
| Professional | $16.29 | $16.29 | $51.57 | |
United
| Professional | $10.28 | $17.18 | $25.82 |