| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.98 | $1,691.31 | $11,989.17 | |
Aetna
| Facility | 50 | $0.98 | $47.19 | $7,960.92 |
Cigna
| Facility | $2,828.59 | $2,828.59 | $2,828.59 | |
Kaiser Permanente
| Professional | $800.78 | $1,033.02 | $1,709.78 |