| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $815.00 | $8,766.92 | $14,536.95 | |
Cigna
| Facility | $3,173.57 | $3,173.57 | $3,173.57 | |
Kaiser Permanente
| Professional | $684.11 | $882.50 | $1,464.52 | |
United
| Facility | $3,522.00 | $3,522.00 | $3,522.00 |