| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,464.00 | $6,456.00 | |
Aetna
| Facility | 50 | $1,136.50 | $2,340.00 | $7,107.00 |
Kaiser Permanente
| Professional | $593.23 | $1,296.42 | $1,296.42 | |
United
| Facility | $3,261.00 | $4,165.00 | $26,408.00 |