| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.14 | $2,259.25 | $7,223.58 | |
Aetna
| Facility | 50 | $0.98 | $2,333.54 | $9,708.91 |
Cigna
| Facility | $5,607.14 | $5,607.14 | $5,607.14 | |
Kaiser Permanente
| Professional | $1,222.21 | $1,625.54 | $2,644.83 |