| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $254.96 | $2,355.23 | $4,913.68 | |
Cigna
| Facility | $508.00 | $909.33 | $1,530.89 | |
Cigna
| Facility | 52 | $204.01 | $204.01 | $204.01 |
Kaiser Permanente
| Professional | $224.04 | $283.00 | $476.34 | |
United
| Facility | $418.00 | $453.00 | $1,330.00 |