| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $615.26 | $615.26 | $615.26 | |
Aetna
| Professional | $593.54 | $615.26 | $615.26 | |
Cigna
| Facility | $615.26 | $615.26 | $615.26 | |
Cigna
| Professional | $615.26 | $615.26 | $615.26 | |
Kaiser Permanente
| Professional | $651.79 | $651.79 | $724.22 | |
United
| Professional | $723.84 | $723.84 | $753.08 |