| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.65 | $38.65 | $38.65 | |
Cigna
| Facility | $715.00 | $728.96 | $1,490.90 | |
Kaiser Permanente
| Professional | $757.88 | $977.67 | $1,296.26 | |
United
| Facility | $643.00 | $643.00 | $1,185.00 |