| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,995.26 | $2,818.38 | $20,892.96 | |
Kaiser Permanente
| Facility | $1,380.38 | $2,344.23 | $3,019.95 | |
Pacific Source
| Facility | $1,778.28 | $2,041.74 | $2,187.76 | |
Premera BCBS
| Facility | $1,513.56 | $1,513.56 | $1,513.56 | |
United
| Facility | $1,122.02 | $3,311.31 | $37,153.52 |