| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,818.38 | $2,818.38 | $2,818.38 | |
Aetna
| Professional | $26.92 | $93.33 | $112.20 | |
Cigna
| Professional | $100.00 | $100.00 | $141.25 | |
Kaiser Permanente
| Professional | $77.62 | $120.23 | $147.91 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 | |
United
| Professional | $83.18 | $120.23 | $169.82 |