| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $611.16 | $1,614.00 | $7,727.00 | |
Aetna
| Facility | 53 | $122.23 | $122.23 | $122.23 |
Cigna
| Facility | $13,832.00 | $20,514.00 | $37,262.00 | |
Kaiser Permanente
| Professional | $1,439.68 | $1,439.68 | $1,439.68 | |
United
| Facility | $4,062.00 | $5,185.00 | $70,978.00 |