| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $23.40 | $38.79 | $45.70 | |
HealthNet
| Facility | $54.70 | $166.98 | $256.24 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 | |
United
| Facility | $2,085.00 | $2,085.00 | $2,085.00 |