| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,019.95 | $5,888.44 | $21,877.62 | |
Kaiser Permanente
| Facility | $2,951.21 | $5,128.61 | $6,309.57 | |
Pacific Source
| Facility | $3,890.45 | $4,570.88 | $4,786.30 | |
Premera BCBS
| Facility | $3,235.94 | $3,235.94 | $3,235.94 | |
United
| Facility | $1,122.02 | $3,311.31 | $37,153.52 |