| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $457.09 | $457.09 | $457.09 | |
Cigna
| Facility | $199.53 | $199.53 | $199.53 | |
Kaiser Permanente
| Professional | $223.87 | $288.40 | $398.11 | |
United
| Facility | $95.50 | $229.09 | $426.58 |