| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,471.42 | $3,471.42 | $3,471.42 | |
Cigna
| Facility | $330.00 | $356.50 | $641.21 | |
Kaiser Permanente
| Professional | $268.67 | $346.84 | $527.29 | |
United
| Facility | $123.00 | $123.00 | $158.00 |