| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.54 | $371.54 | $371.54 | |
Aetna
| Professional | $363.08 | $371.54 | $512.86 | |
Cigna
| Professional | $371.54 | $371.54 | $371.54 | |
Kaiser Permanente
| Professional | $7.59 | $10.96 | $416.87 | |
United
| Facility | $416.87 | $416.87 | $416.87 | |
United
| Professional | $371.54 | $407.38 | $467.74 |