| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $519.13 | $519.13 | $916.97 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
University Health Alliance
| Professional | $2,884.00 | $9,125.00 | $9,934.00 |