| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $99.71 | $99.71 | $99.71 | |
Kaiser Permanente
| Professional | $94.93 | $205.63 | $205.63 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $78.90 | $114.36 | $274.87 |