| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,200.00 | $1,200.00 | $1,200.00 | |
Cigna
| Facility | $4,790.00 | $4,790.00 | $4,790.00 | |
Kaiser Permanente
| Facility | $110.00 | $110.00 | $280.00 | |
United
| Facility | $1,200.00 | $1,602.00 | $5,309.00 | |
University Health Alliance
| Facility | $110.00 | $110.00 | $110.00 |