| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $397.79 | $397.79 | $397.79 | |
Kaiser Permanente
| Professional | $402.02 | $870.48 | $870.48 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $362.07 | $913.03 | $1,025.86 |