| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $326.45 | $558.02 | $558.02 | |
CareSource
| Facility | $416.39 | $525.91 | $750.50 | |
Cigna
| Facility | $451.80 | $451.80 | $451.80 | |
Kaiser Permanente
| Professional | $386.64 | $525.35 | $3,688.00 |