| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $993.00 | $3,635.26 | $5,843.43 | |
Cigna
| Facility | $119.30 | $119.30 | $927.56 | |
Kaiser Permanente
| Professional | $95.40 | $123.45 | $179.57 | |
United
| Facility | $450.00 | $450.00 | $471.00 |