| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.29 | $47.23 | $80.77 | |
Cigna
| Facility | $75.05 | $75.05 | $75.05 | |
Cigna
| Professional | $54.79 | $54.79 | $54.79 | |
Kaiser Permanente
| Professional | $83.79 | $102.95 | $143.02 | |
United
| Professional | $50.90 | $70.59 | $113.15 | |
Wellpoint
| Professional | $93.65 | $93.66 | $93.66 |