| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,004.21 | $2,666.05 | $14,385.89 | |
Aetna
| Facility | 50 | $0.99 | $4,618.60 | $6,304.87 |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $342.31 | $455.27 | $727.54 |