| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,311.31 | $9,332.54 | $22,908.68 | |
Kaiser Permanente
| Facility | $2,238.72 | $3,801.89 | $4,786.30 | |
Pacific Source
| Facility | $2,884.03 | $3,311.31 | $3,630.78 | |
Premera BCBS
| Facility | $2,454.71 | $2,454.71 | $2,454.71 | |
United
| Facility | $1,122.02 | $3,311.31 | $37,153.52 |