| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $843.38 | $5,463.90 | $14,763.00 | |
Aetna
| Professional | $4,390.39 | $5,160.84 | $15,936.00 | |
Cigna
| Professional | $3,467.91 | $3,467.91 | $3,467.91 | |
Kaiser Permanente
| Professional | $98.34 | $98.34 | $100.00 |