| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $13.60 | $13.60 | $13.60 | |
Kaiser Permanente
| Professional | $31.45 | $34.31 | $40.03 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
United
| Professional | $25.10 | $68.98 | $99.59 |