| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $303.14 | $303.14 | $303.14 | |
Kaiser Permanente
| Professional | $159.08 | $625.14 | $625.14 | |
United
| Facility | $665.00 | $762.00 | $6,342.00 | |
United
| Professional | $237.67 | $571.49 | $1,130.61 |