| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.98 | $292.85 | $6,531.65 | |
Aetna
| Facility | 50 | $0.98 | $2,822.82 | $4,158.93 |
Kaiser Permanente
| Professional | $220.04 | $272.43 | $476.81 | |
United
| Facility | $150.00 | $150.00 | $150.00 |