| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $374.98 | $374.98 | $374.98 | |
Aetna
| Professional | $374.98 | $374.98 | $479.97 | |
Cigna
| Professional | $374.98 | $374.98 | $374.98 | |
Kaiser Permanente
| Professional | $7.32 | $10.55 | $397.04 | |
United
| Professional | $367.63 | $367.63 | $530.30 |