| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.00 | $4,407.50 | $9,719.00 | |
Cigna
| Facility | $9,228.00 | $13,832.00 | $62,695.00 | |
Kaiser Permanente
| Professional | $1,273.83 | $1,273.83 | $1,273.83 | |
United
| Facility | $4,062.00 | $18,057.00 | $48,120.00 |