| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.29 | $194.29 | $1,340.00 | |
Aetna
| Professional | $190.79 | $194.29 | $240.00 | |
Cigna
| Professional | $146.27 | $146.27 | $314.33 | |
Kaiser Permanente
| Professional | $205.12 | $451.44 | $451.44 | |
United
| Professional | $127.44 | $241.51 | $499.95 |