| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.43 | $79.43 | $100.00 | |
Kaiser Permanente
| Facility | $109.65 | $109.65 | $281.84 | |
United
| Facility | $724.44 | $724.44 | $724.44 | |
University Health Alliance
| Facility | $109.65 | $109.65 | $323.59 |