| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,818.38 | $2,818.38 | $2,818.38 | |
Aetna
| Professional | $186.21 | $229.09 | $257.04 | |
Kaiser Permanente
| Professional | $275.42 | $549.54 | $691.83 | |
United
| Professional | $229.09 | $263.03 | $331.13 |