| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $479.56 | $532.32 | $2,128.42 | |
Aetna
| Facility | 50 | $0.98 | $78.40 | $2,779.39 |
Cigna
| Facility | $2,558.05 | $2,558.05 | $2,558.05 | |
Kaiser Permanente
| Professional | $457.70 | $590.42 | $971.31 |