| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $331.13 | $4,365.16 | |
Aetna
| Facility | 50 | $64.57 | $64.57 | $4,677.35 |
Aetna
| Professional | 50 | $147.91 | $407.38 | $1,122.02 |
Cigna
| Facility | $204.17 | $204.17 | $204.17 | |
Kaiser Permanente
| Professional | $204.17 | $323.59 | $436.52 | |
United
| Facility | $83.18 | $194.98 | $426.58 |