| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $3,162.00 | $4,100.00 | |
Aetna
| Professional | $189.93 | $316.27 | $316.27 | |
Kaiser Permanente
| Professional | $338.93 | $356.77 | $687.36 | |
United
| Facility | $808.00 | $1,171.00 | $26,408.00 | |
United
| Professional | $250.90 | $362.81 | $808.83 |