| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $870.96 | $870.96 | $1,621.81 | |
Ambetter
| Facility | $436.52 | $676.08 | $1,148.15 | |
Cigna
| Facility | $616.60 | $870.96 | $1,584.89 | |
Kaiser Permanente
| Facility | $1,737.80 | $1,737.80 | $1,737.80 |