| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $4,466.84 | $4,466.84 | |
Aetna
| Professional | $363.08 | $363.08 | $363.08 | |
Kaiser Permanente
| Professional | $199.53 | $199.53 | $199.53 | |
United
| Facility | $1,698.24 | $1,698.24 | $1,698.24 | |
University Health Alliance
| Professional | $1,778.28 | $3,981.07 | $6,165.95 |