| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $98.50 | $98.50 | $98.50 | |
Cigna
| Professional | $100.90 | $100.90 | $142.44 | |
Kaiser Permanente
| Professional | $78.28 | $121.85 | $143.69 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 | |
United
| Professional | $89.62 | $131.35 | $171.68 |