| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $3,235.94 | $8,709.64 | |
Aetna
| Facility | 50 | $18,620.87 | $19,054.61 | $19,054.61 |
Anthem BCBS
| Facility | $4,570.88 | $9,549.93 | $17,378.01 | |
Kaiser Permanente
| Professional | $741.31 | $812.83 | $1,949.84 | |
United
| Facility | $2,630.27 | $5,754.40 | $12,302.69 |