| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,461.21 | $7,068.88 | $12,332.18 | |
Aetna
| Facility | 50 | $8,304.20 | $8,304.20 | $8,304.20 |
Cigna
| Facility | $5,040.18 | $5,040.18 | $5,040.18 | |
Kaiser Permanente
| Professional | $1,151.83 | $1,531.95 | $2,575.05 | |
United
| Facility | $2,882.00 | $2,882.00 | $2,882.00 |