| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.38 | $18.38 | $18.38 | |
Cigna
| Facility | $507.00 | $507.00 | $641.21 | |
Kaiser Permanente
| Professional | $1,261.32 | $1,633.64 | $2,124.32 | |
United
| Facility | $1,003.00 | $2,156.00 | $3,522.00 |