| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.97 | $223.87 | $389.05 | |
Kaiser Permanente
| Facility | $147.91 | $302.00 | $398.11 | |
Pacific Source
| Facility | $257.04 | $309.03 | $323.59 | |
Premera BCBS
| Facility | $204.17 | $204.17 | $218.78 |