| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $277.99 | $463.43 | $463.43 | |
CareSource
| Facility | $386.19 | $386.19 | $386.19 | |
Cigna
| Facility | $382.54 | $382.54 | $382.54 | |
Kaiser Permanente
| Professional | $327.54 | $444.39 | $2,964.00 |