| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,232.00 | $2,464.00 | $4,975.00 | |
Aetna
| Facility | 50 | $999.75 | $2,487.50 | $4,738.00 |
Kaiser Permanente
| Professional | $845.34 | $1,750.52 | $1,750.52 | |
United
| Facility | $4,062.00 | $5,185.00 | $19,046.00 |