| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,949.84 | $5,495.41 | $5,495.41 | |
Aetna
| Professional | $45.71 | $61.66 | $338.84 | |
Kaiser Permanente
| Professional | $398.11 | $426.58 | $501.19 | |
United
| Facility | $3,311.31 | $3,311.31 | $3,311.31 | |
United
| Professional | $61.66 | $72.44 | $87.10 |