| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,818.38 | $2,818.38 | $2,818.38 | |
Aetna
| Professional | $15.85 | $52.48 | $95.50 | |
Cigna
| Professional | $28.18 | $74.13 | $112.20 | |
Kaiser Permanente
| Professional | $20.89 | $89.13 | $114.82 | |
United
| Professional | $20.89 | $54.95 | $109.65 |