| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $6,025.60 | $6,025.60 | |
Aetna
| Professional | $169.82 | $2,570.40 | $4,897.79 | |
Kaiser Permanente
| Professional | $676.08 | $676.08 | $676.08 | |
United
| Facility | $2,884.03 | $2,884.03 | $2,884.03 | |
University Health Alliance
| Professional | $29.51 | $29.51 | $5,888.44 |