| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $2,884.03 | $2,884.03 | |
Aetna
| Professional | $128.82 | $204.17 | $363.08 | |
Kaiser Permanente
| Professional | $91.20 | $158.49 | $199.53 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 | |
United
| Professional | $57.54 | $72.44 | $79.43 |