| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.33 | $8.33 | $8.33 | |
Aetna
| Professional | $8.33 | $8.33 | $8.33 | |
Cigna
| Professional | $3.75 | $3.75 | $4.69 | |
Kaiser Permanente
| Professional | $24.60 | $24.60 | $24.60 | |
United
| Professional | $6.50 | $20.87 | $29.09 |