| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,187.33 | $1,187.33 | $1,187.33 | |
Cigna
| Facility | $419.80 | $419.80 | $419.80 | |
Cigna
| Professional | $1,755.54 | $1,755.54 | $1,755.54 | |
Kaiser Permanente
| Professional | $122.52 | $361.06 | $451.33 | |
United
| Professional | $218.85 | $541.60 | $588.48 |