| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,818.38 | $2,818.38 | $2,818.38 | |
Aetna
| Professional | $12.88 | $57.54 | $72.44 | |
Kaiser Permanente
| Professional | $31.62 | $34.67 | $42.66 | |
United
| Facility | $2,884.03 | $2,884.03 | $2,884.03 | |
United
| Professional | $25.12 | $41.69 | $100.00 |