| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $355.58 | $475.89 | $570.75 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $432.68 | $718.26 | $899.81 |