| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.21 | $770.22 | $2,151.64 | |
Cigna
| Facility | $508.00 | $909.33 | $1,530.89 | |
Cigna
| Facility | 52 | $172.10 | $172.10 | $172.10 |
Kaiser Permanente
| Professional | $188.12 | $237.62 | $401.09 | |
United
| Facility | $418.00 | $453.00 | $1,330.00 |