| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,563.00 | $1,563.00 | $1,563.00 | |
Aetna
| Professional | $1,563.00 | $1,563.00 | $1,563.00 | |
Denver HMP
| Facility | $1,563.00 | $1,563.00 | $2,625.84 | |
Kaiser Permanente
| Professional | $155.00 | $155.00 | $329.00 |