| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,258.93 | $1,258.93 | $1,258.93 | |
Cigna
| Facility | $645.65 | $676.08 | $1,000.00 | |
Kaiser Permanente
| Facility | $117.49 | $194.98 | $316.23 | |
Providence
| Facility | $977.24 | $977.24 | $1,000.00 |