| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $281.84 | $1,737.80 | $20,892.96 | |
Kaiser Permanente
| Facility | $190.55 | $316.23 | $389.05 | |
Pacific Source
| Facility | $251.19 | $288.40 | $309.03 | |
Premera BCBS
| Facility | $208.93 | $208.93 | $208.93 | |
United
| Facility | $707.95 | $2,454.71 | $37,153.52 |