| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,569.57 | $4,144.00 | $8,043.00 | |
Aetna
| Facility | 52 | $784.79 | $784.79 | $784.79 |
Kaiser Permanente
| Professional | $1,668.31 | $3,459.92 | $3,459.92 | |
United
| Facility | $7,840.00 | $10,006.00 | $47,612.00 |