| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.66 | $61.66 | $61.66 | |
Aetna
| Professional | $63.10 | $74.13 | $102.33 | |
Cigna
| Professional | $25.70 | $52.48 | $123.03 | |
Kaiser Permanente
| Professional | $676.08 | $676.08 | $676.08 | |
United
| Professional | $41.69 | $57.54 | $102.33 |