| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $534.07 | $534.07 | $534.07 | |
CareSource
| Facility | $560.39 | $560.39 | $560.39 | |
Cigna
| Facility | $594.32 | $594.32 | $594.32 | |
Kaiser Permanente
| Professional | $506.12 | $657.96 | $1,659.00 |