| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,454.71 | $3,388.44 | $20,892.96 | |
Kaiser Permanente
| Facility | $1,621.81 | $2,691.53 | $3,388.44 | |
Pacific Source
| Facility | $2,187.76 | $2,570.40 | $2,630.27 | |
Premera BCBS
| Facility | $1,737.80 | $1,737.80 | $1,819.70 | |
United
| Facility | $707.95 | $2,454.71 | $37,153.52 |