| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.93 | $851.14 | $2,691.53 | |
Cigna
| Facility | $512.86 | $812.83 | $1,148.15 | |
Cigna
| Facility | 52 | $263.03 | $263.03 | $263.03 |
Kaiser Permanente
| Professional | $151.36 | $199.53 | $288.40 | |
United
| Facility | $416.87 | $524.81 | $1,318.26 |