| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,713.38 | $1,713.38 | $1,713.38 | |
Cigna
| Facility | $599.00 | $599.00 | $634.82 | |
Kaiser Permanente
| Professional | $125.65 | $144.50 | $199.16 | |
United
| Facility | $89.00 | $89.00 | $89.00 |