| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,230.27 | $3,890.45 | $6,456.54 | |
Aetna
| Facility | 50 | $1,995.26 | $3,715.35 | $7,079.46 |
Kaiser Permanente
| Professional | $549.54 | $1,258.93 | $1,288.25 | |
United
| Facility | $4,073.80 | $16,218.10 | $35,481.34 |