| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,210.10 | $6,135.10 | $11,898.54 | |
Aetna
| Facility | 50 | $2,320.21 | $9,339.12 | $15,811.07 |
Cigna
| Facility | $2,828.59 | $2,828.59 | $2,828.59 | |
Kaiser Permanente
| Professional | $1,013.46 | $1,307.35 | $2,163.37 |