| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Kaiser Permanente
| Professional | $111.95 | $127.37 | $144.74 | |
United
| Facility | $1,981.00 | $1,981.00 | $1,981.00 | |
United
| Professional | $157.66 | $184.73 | $187.61 |