| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $2,884.03 | $2,884.03 | |
Aetna
| Professional | $85.11 | $104.71 | $407.38 | |
Cigna
| Professional | $91.20 | $91.20 | $128.82 | |
Kaiser Permanente
| Professional | $66.07 | $112.20 | $134.90 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 | |
United
| Professional | $77.62 | $112.20 | $154.88 |