| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $438.83 | $438.83 | $438.83 | |
Aetna
| Professional | $395.72 | $438.83 | $868.37 | |
Cigna
| Professional | $272.50 | $272.50 | $272.50 | |
Kaiser Permanente
| Professional | $172.70 | $206.72 | $480.51 | |
United
| Professional | $593.59 | $885.10 | $1,765.17 |