| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.86 | $40.86 | $40.86 | |
Cigna
| Facility | $627.00 | $641.21 | $1,490.90 | |
Kaiser Permanente
| Professional | $513.27 | $662.12 | $868.21 | |
United
| Facility | $643.00 | $643.00 | $1,185.00 |