| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,008.93 | $2,008.93 | $2,008.93 | |
Aetna
| Professional | $1,732.59 | $1,878.70 | $2,008.93 | |
Kaiser Permanente
| Professional | $1,231.63 | $1,638.07 | $4,250.83 | |
United
| Professional | $1,489.25 | $2,100.65 | $3,451.84 |