| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.40 | $1,114.30 | $1,114.30 | |
Cigna
| Facility | $507.00 | $518.54 | $1,490.90 | |
Kaiser Permanente
| Professional | $463.80 | $598.29 | $781.73 | |
United
| Facility | $520.00 | $520.00 | $733.00 |