| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.49 | $158.49 | $478.63 | |
Blue Shield
| Facility | $56.23 | $89.13 | $100.00 | |
Cigna
| Facility | $199.53 | $524.81 | $537.03 | |
Kaiser Permanente
| Facility | $117.49 | $194.98 | $331.13 | |
Providence
| Facility | $199.53 | $524.81 | $537.03 |