| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $185.01 | $185.01 | $185.01 | |
Kaiser Permanente
| Professional | $297.22 | $602.78 | $684.98 | |
United
| Professional | $231.49 | $315.74 | $329.00 |