| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $390.18 | $390.18 | $390.18 | |
Aetna
| Professional | $84.08 | $390.18 | $390.18 | |
Cigna
| Professional | $785.24 | $785.24 | $785.24 | |
Kaiser Permanente
| Professional | $261.81 | $261.81 | $1,294.79 | |
United
| Professional | $1,438.66 | $1,438.66 | $2,331.75 |