| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,951.21 | $5,754.40 | $20,892.96 | |
Kaiser Permanente
| Facility | $2,884.03 | $5,011.87 | $6,456.54 | |
Pacific Source
| Facility | $3,801.89 | $4,466.84 | $4,677.35 | |
Premera BCBS
| Facility | $3,162.28 | $3,162.28 | $3,235.94 | |
United
| Facility | $1,122.02 | $3,311.31 | $37,153.52 |