| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.87 | $118.87 | $3,735.10 | |
Cigna
| Facility | $627.00 | $641.21 | $1,490.90 | |
Kaiser Permanente
| Professional | $531.29 | $685.36 | $1,098.03 | |
United
| Facility | $643.00 | $1,185.00 | $2,229.00 |