| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.98 | $939.86 | $5,734.53 | |
Aetna
| Facility | 50 | $0.98 | $3,486.38 | $3,648.84 |
Cigna
| Facility | $1,621.87 | $1,621.87 | $1,621.87 | |
Kaiser Permanente
| Professional | $708.58 | $914.07 | $1,513.79 |