| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,630.27 | $2,630.27 | $12,882.50 | |
Cigna
| Facility | $2,630.27 | $2,630.27 | $2,630.27 | |
Kaiser Permanente
| Professional | $758.58 | $870.96 | $1,380.38 | |
United
| Facility | $2,238.72 | $2,238.72 | $2,238.72 |