| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $6,966.00 | $8,499.00 | |
Aetna
| Professional | $4,404.71 | $4,404.71 | $4,404.71 | |
Cigna
| Professional | $1,178.42 | $1,178.42 | $1,663.64 | |
Kaiser Permanente
| Professional | $2,320.94 | $2,531.94 | $2,953.93 | |
United
| Facility | $3,028.00 | $3,028.00 | $3,028.00 | |
United
| Professional | $1,178.42 | $3,395.47 | $3,925.46 |