| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,698.24 | $4,897.79 | $6,918.31 | |
Aetna
| Facility | 50 | $4,570.88 | $5,888.44 | $7,413.10 |
Kaiser Permanente
| Professional | $691.83 | $1,621.81 | $1,621.81 | |
United
| Facility | $3,311.31 | $16,218.10 | $26,915.35 |