| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $724.44 | $3,548.13 | $10,715.19 | |
Aetna
| Facility | 50 | $1,023.29 | $4,365.16 | $12,302.69 |
Anthem BCBS
| Facility | $4,570.88 | $10,000.00 | $17,782.79 | |
Kaiser Permanente
| Professional | $912.01 | $933.25 | $5,370.32 | |
United
| Facility | $3,548.13 | $8,128.31 | $16,595.87 |