| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $1,121.31 | $1,121.31 | $1,121.31 | |
Kaiser Permanente
| Professional | $1,798.24 | $1,961.71 | $2,288.66 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $2,185.21 | $2,365.88 | $2,964.53 | |
University Health Alliance
| Professional | $29.27 | $29.27 | $29.27 |