| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.87 | $14.87 | $1,303.68 | |
Cigna
| Facility | $627.00 | $641.21 | $4,418.22 | |
Kaiser Permanente
| Professional | $691.60 | $892.16 | $1,174.30 | |
United
| Facility | $847.00 | $847.00 | $1,560.00 |