| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $698.50 | $698.50 | $698.50 | |
Cigna
| Professional | $701.25 | $701.25 | $990.00 | |
Kaiser Permanente
| Professional | $329.22 | $1,757.42 | $2,072.42 | |
United
| Facility | $2,155.00 | $2,155.00 | $2,155.00 | |
United
| Professional | $701.25 | $2,412.42 | $4,365.57 |