| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,324.03 | $2,747.00 | $4,456.00 | |
Kaiser Permanente
| Professional | $200.00 | $200.00 | $200.00 | |
United
| Facility | $2,155.00 | $2,155.00 | $2,155.00 | |
United
| Professional | $2,348.78 | $3,841.73 | $6,253.66 | |
University Health Alliance
| Professional | $1,005.00 | $3,242.65 | $6,124.00 |