| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $224.35 | $241.62 | $300.62 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Facility | $1,689.00 | $1,689.00 | $1,689.00 | |
United
| Professional | $247.37 | $361.56 | $428.60 |