| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $648.07 | $648.07 | $648.07 | |
Cigna
| Facility | $445.00 | $453.73 | $791.44 | |
Kaiser Permanente
| Professional | $591.64 | $763.22 | $1,002.82 | |
United
| Facility | $215.00 | $215.00 | $471.00 |