| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,057.07 | $2,057.07 | $2,057.07 | |
Cigna
| Facility | $507.00 | $507.00 | $641.21 | |
Kaiser Permanente
| Professional | $372.93 | $492.87 | $638.33 | |
United
| Facility | $36.00 | $36.00 | $41.00 |