| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.41 | $3,300.54 | $4,699.43 | |
Cigna
| Facility | $330.00 | $339.05 | $791.44 | |
Kaiser Permanente
| Professional | $456.76 | $589.22 | $780.98 | |
United
| Facility | $215.00 | $215.00 | $471.00 |