| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $192.80 | $192.80 | $192.80 | |
Cigna
| Professional | $320.31 | $320.31 | $452.21 | |
Kaiser Permanente
| Professional | $401.43 | $437.93 | $510.92 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
United
| Professional | $320.31 | $449.13 | $528.16 |