| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.05 | $3,411.50 | $4,947.34 | |
Cigna
| Facility | $627.00 | $641.21 | $791.44 | |
Kaiser Permanente
| Professional | $656.58 | $846.99 | $1,133.07 | |
United
| Facility | $215.00 | $215.00 | $471.00 |