| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $360.71 | $397.88 | $518.59 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $405.04 | $577.89 | $738.14 |