| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $478.63 | $478.63 | $478.63 | |
Aetna
| Professional | $389.05 | $478.63 | $489.78 | |
Cigna
| Facility | $478.63 | $478.63 | $478.63 | |
Kaiser Permanente
| Professional | $724.44 | $724.44 | $724.44 | |
United
| Professional | $467.74 | $467.74 | $758.58 |