| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,932.70 | $1,932.70 | $1,932.70 | |
Aetna
| Professional | $1,666.13 | $1,822.70 | $2,086.44 | |
Cigna
| Professional | $2,373.25 | $2,490.73 | $2,984.18 | |
Kaiser Permanente
| Professional | $1,339.23 | $2,045.13 | $2,720.02 |