| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,625.93 | $2,625.93 | $2,625.93 | |
Cigna
| Facility | $627.00 | $641.21 | $791.44 | |
Kaiser Permanente
| Professional | $430.97 | $555.95 | $847.11 | |
United
| Facility | $215.00 | $215.00 | $471.00 |