| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $891.25 | $891.25 | $891.25 | |
Aetna
| Professional | $30.90 | $33.88 | $69.18 | |
Cigna
| Professional | $2.04 | $2.04 | $2.04 | |
Kaiser Permanente
| Professional | $281.84 | $323.59 | $389.05 |