| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $2,884.03 | $2,884.03 | |
Aetna
| Professional | $25.70 | $162.18 | $257.04 | |
Kaiser Permanente
| Professional | $162.18 | $173.78 | $204.17 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 | |
United
| Professional | $24.55 | $33.11 | $47.86 |