| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,491.94 | $3,699.44 | $24,426.21 | |
Aetna
| Facility | 50 | $2,333.52 | $2,333.52 | $2,333.52 |
Cigna
| Facility | $2,828.59 | $2,828.59 | $2,828.59 | |
Kaiser Permanente
| Professional | $1,245.06 | $1,606.13 | $2,679.63 |