| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $1,680.00 | $1,776.00 | |
Aetna
| Professional | $30.00 | $30.00 | $1,280.00 | |
Cigna
| Professional | $690.00 | $1,200.45 | $1,498.05 | |
Kaiser Permanente
| Professional | $1,126.56 | $1,126.56 | $1,216.00 | |
United
| Professional | $46.00 | $81.14 | $111.59 |