| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,750.00 | $2,750.00 | $2,750.00 | |
Ambetter
| Facility | $71.36 | $874.28 | $4,541.58 | |
Cigna
| Facility | $7,350.00 | $7,350.00 | $7,350.00 | |
HealthNet
| Facility | $1,923.89 | $7,717.39 | $25,711.61 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 |