| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.98 | $619.28 | $2,801.14 | |
Aetna
| Facility | 50 | $0.98 | $4,320.27 | $5,201.21 |
Cigna
| Facility | $3,347.40 | $3,347.40 | $3,347.40 | |
Kaiser Permanente
| Professional | $649.78 | $864.21 | $1,390.04 |