| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.88 | $992.58 | $2,766.99 | |
Cigna
| Facility | $508.00 | $1,474.16 | $2,213.00 | |
Cigna
| Facility | 52 | $94.25 | $94.25 | $94.25 |
Kaiser Permanente
| Professional | $104.47 | $127.27 | $217.34 | |
United
| Facility | $418.00 | $453.00 | $1,330.00 |