| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $555.19 | $2,113.46 | $3,862.59 | |
Aetna
| Facility | 50 | $2,434.64 | $2,434.64 | $2,434.64 |
Kaiser Permanente
| Professional | $578.96 | $672.03 | $1,236.83 | |
United
| Facility | $950.00 | $950.00 | $950.00 |