| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,486.00 | $3,883.00 | $4,705.00 | |
Aetna
| Professional | $327.97 | $362.47 | $469.25 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Facility | $1,689.00 | $1,689.00 | $1,689.00 | |
United
| Professional | $369.02 | $621.90 | $843.26 |