| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.00 | $24.00 | $24.00 | |
Aetna
| Professional | $1.57 | $9.60 | $10.93 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $10.60 | $10.60 | $10.60 | |
Kaiser Permanente
| Professional | $24.00 | $24.00 | $24.00 | |
United
| Facility | $16.80 | $16.80 | $16.80 | |
United
| Professional | $17.76 | $24.00 | $42.11 |