| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $974.76 | $974.76 | $974.76 | |
Kaiser Permanente
| Professional | $1,665.04 | $1,816.40 | $2,119.14 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $1,897.79 | $2,190.63 | $2,587.83 | |
University Health Alliance
| Professional | $29.27 | $29.27 | $29.27 |