| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,750.00 | $2,750.00 | $2,750.00 | |
Ambetter
| Facility | $76.45 | $2,260.23 | $8,140.25 | |
HealthNet
| Facility | $2,537.66 | $9,669.59 | $31,167.21 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 |