| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,698.24 | $3,388.44 | $6,456.54 | |
Aetna
| Facility | 50 | $933.25 | $4,786.30 | $7,413.10 |
Kaiser Permanente
| Professional | $741.31 | $1,737.80 | $1,905.46 | |
United
| Facility | $4,897.79 | $13,489.63 | $42,657.95 |