| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $222.36 | $222.36 | $222.36 | |
Kaiser Permanente
| Professional | $339.63 | $519.33 | $519.33 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 | |
United
| Professional | $201.26 | $507.41 | $985.67 |