| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 50 | $1,103.08 | $1,103.08 | $1,316.57 |
Aetna
| Professional | 50 | $3,570.00 | $3,570.00 | $3,570.00 |
Kaiser Permanente
| Professional | $474.83 | $587.89 | $921.21 | |
United
| Facility | $450.00 | $450.00 | $450.00 |