| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,898.00 | $3,444.00 | |
Kaiser Permanente
| Professional | $200.00 | $200.00 | $200.00 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 | |
United
| Professional | $214.51 | $283.64 | $747.23 |