| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $84.00 | $84.00 | $84.00 | |
Kaiser Permanente
| Professional | $182.24 | $198.80 | $231.94 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
United
| Professional | $145.41 | $239.78 | $259.63 |