| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $8,431.00 | $10,303.00 | |
Aetna
| Professional | $1,203.15 | $1,203.15 | $1,203.15 | |
Kaiser Permanente
| Professional | $493.76 | $2,050.28 | $2,329.86 | |
United
| Facility | $3,028.00 | $3,028.00 | $3,028.00 | |
United
| Professional | $1,587.57 | $2,123.03 | $2,158.87 |