| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,511.71 | $4,144.00 | $8,043.00 | |
Aetna
| Facility | 52 | $755.86 | $755.86 | $755.86 |
Kaiser Permanente
| Professional | $1,606.90 | $3,333.08 | $3,333.08 | |
United
| Facility | $7,840.00 | $10,006.00 | $47,612.00 |