| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $223.29 | $924.60 | $3,063.68 | |
Aetna
| Facility | 50 | $504.72 | $504.72 | $504.72 |
Cigna
| Facility | $330.00 | $339.05 | $791.44 | |
Kaiser Permanente
| Professional | $165.81 | $213.89 | $281.30 | |
United
| Facility | $215.00 | $215.00 | $471.00 |