| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.53 | $162.53 | $162.53 | |
Cigna
| Facility | $13,832.00 | $20,514.00 | $37,262.00 | |
Kaiser Permanente
| Professional | $384.20 | $384.20 | $384.20 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |