| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $463.15 | $779.25 | $779.25 | |
CareSource
| Facility | $649.38 | $649.38 | $649.38 | |
Cigna
| Facility | $635.70 | $635.70 | $635.70 | |
Kaiser Permanente
| Professional | $539.97 | $732.96 | $3,537.00 |