| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $43.31 | $43.31 | $43.31 | |
Aetna
| Facility | 50 | $1,862.98 | $1,862.98 | $1,862.98 |
Cigna
| Facility | $599.00 | $599.00 | $634.82 | |
Kaiser Permanente
| Professional | $205.44 | $236.26 | $324.92 | |
United
| Facility | $89.00 | $89.00 | $89.00 |