| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.39 | $1,370.26 | $4,589.21 | |
Cigna
| Facility | $582.00 | $4,332.60 | $6,644.00 | |
Cigna
| Facility | 52 | $191.49 | $191.49 | $191.49 |
Kaiser Permanente
| Professional | $207.71 | $265.31 | $447.03 | |
United
| Facility | $1,028.00 | $1,347.00 | $3,219.00 |