| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $355.88 | $355.88 | $355.88 | |
Cigna
| Facility | $408.00 | $408.00 | $408.00 | |
Cigna
| Professional | $408.00 | $408.00 | $408.00 | |
Kaiser Permanente
| Professional | $669.00 | $669.00 | $669.00 | |
United
| Professional | $480.00 | $480.00 | $777.97 |