| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,873.00 | $2,122.00 | $5,856.00 | |
Kaiser Permanente
| Facility | $135.00 | $205.00 | $315.00 | |
Lucent Health
| Facility | $4,002.00 | $5,000.00 | $5,000.00 | |
United
| Facility | $1,144.00 | $1,747.00 | $1,747.00 |