| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,981.36 | $7,981.36 | $7,981.36 | |
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $200.73 | $200.73 | $200.73 |
Kaiser Permanente
| Professional | $1,745.09 | $2,151.52 | $3,102.38 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |