| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $5,076.00 | $6,945.00 | |
Aetna
| Professional | $382.15 | $382.15 | $382.15 | |
Kaiser Permanente
| Professional | $787.96 | $787.96 | $787.96 | |
United
| Facility | $7,840.00 | $10,006.00 | $47,612.00 | |
United
| Professional | $396.79 | $931.32 | $957.91 |