| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.00 | $4,100.00 | $7,007.00 | |
Aetna
| Facility | 52 | $830.92 | $830.92 | $830.92 |
Kaiser Permanente
| Professional | $1,761.69 | $3,658.47 | $3,658.47 | |
United
| Facility | $3,261.00 | $4,165.00 | $26,408.00 |