| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $371.73 | $371.73 | $371.73 | |
Kaiser Permanente
| Professional | $500.30 | $500.30 | $500.30 | |
United
| Professional | $465.19 | $626.91 | $1,094.98 |