| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $147.83 | $147.83 | $147.83 | |
Cigna
| Facility | $177.41 | $177.41 | $177.41 | |
Cigna
| Professional | $274.27 | $274.27 | $274.27 | |
Kaiser Permanente
| Professional | $19.35 | $19.35 | $19.35 | |
United
| Professional | $169.52 | $177.41 | $256.62 |