| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $323.72 | $409.45 | $437.82 | |
Kaiser Permanente
| Professional | $451.56 | $575.04 | $871.73 | |
United
| Facility | $3,677.00 | $3,677.00 | $3,677.00 | |
United
| Professional | $275.69 | $359.74 | $644.03 |