| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.88 | $5,495.41 | $10,232.93 | |
Cigna
| Facility | $398.11 | $398.11 | $398.11 | |
Kaiser Permanente
| Professional | $204.17 | $288.40 | $758.58 | |
United
| Facility | $676.08 | $1,479.11 | $3,235.94 |