| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $4,100.00 | |
Aetna
| Professional | $275.14 | $275.14 | $275.14 | |
Kaiser Permanente
| Professional | $262.01 | $567.30 | $567.30 | |
United
| Facility | $4,062.00 | $5,185.00 | $19,046.00 | |
United
| Professional | $244.35 | $524.72 | $709.08 |