| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $152.24 | $152.24 | $152.24 | |
Kaiser Permanente
| Professional | $145.00 | $314.33 | $314.33 | |
United
| Professional | $188.95 | $294.25 | $469.36 |