| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $467.74 | $707.95 | $1,000.00 | |
Cigna
| Professional | $812.83 | $812.83 | $812.83 | |
Kaiser Permanente
| Professional | $977.24 | $1,258.93 | $1,698.24 | |
United
| Professional | $660.69 | $870.96 | $1,621.81 | |
Wellpoint
| Professional | $1,148.15 | $1,318.26 | $1,819.70 |