| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,272.71 | $4,100.00 | $7,007.00 | |
Aetna
| Facility | 54 | $954.53 | $954.53 | $954.53 |
Kaiser Permanente
| Professional | $1,354.02 | $2,808.11 | $2,808.11 | |
United
| Facility | $3,261.00 | $4,165.00 | $26,408.00 |