| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $424.47 | $424.47 | $424.47 | |
Aetna
| Professional | $424.47 | $424.47 | $424.47 | |
Cigna
| Facility | $424.47 | $424.47 | $424.47 | |
Cigna
| Professional | $424.47 | $424.47 | $424.47 | |
Kaiser Permanente
| Professional | $424.51 | $449.48 | $449.48 | |
United
| Professional | $499.42 | $499.42 | $809.45 |