| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $359.03 | $359.03 | $359.03 | |
Aetna
| Professional | $327.70 | $359.03 | $359.03 | |
Cigna
| Professional | $521.23 | $521.23 | $521.23 | |
Kaiser Permanente
| Professional | $334.36 | $395.42 | $740.39 | |
United
| Professional | $266.13 | $408.66 | $1,125.91 |