| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,528.00 | $6,084.00 | $7,424.00 | |
Aetna
| Professional | $1,085.10 | $1,085.11 | $1,128.95 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
University Health Alliance
| Professional | $5,236.00 | $6,283.00 | $7,226.00 |