| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $616.60 | $616.60 | $616.60 | |
Cigna
| Professional | $79.43 | $79.43 | $79.43 | |
Kaiser Permanente
| Professional | $4,168.69 | $4,168.69 | $4,168.69 | |
Molina
| Professional | $44.67 | $50.12 | $75.86 |