| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,488.49 | $1,488.49 | $1,488.49 | |
Cigna
| Facility | $582.00 | $909.33 | $1,530.89 | |
Cigna
| Facility | 52 | $230.55 | $230.55 | $230.55 |
Kaiser Permanente
| Professional | $250.30 | $319.08 | $538.34 | |
United
| Facility | $418.00 | $453.00 | $1,330.00 |