| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $82.23 | $82.23 | $82.23 | |
Kaiser Permanente
| Professional | $78.66 | $170.38 | $170.38 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $68.78 | $99.64 | $212.73 |