| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $4,100.00 | $8,043.00 | |
Aetna
| Facility | 52 | $904.11 | $904.11 | $2,936.64 |
Kaiser Permanente
| Professional | $1,920.85 | $3,986.55 | $3,986.55 | |
United
| Facility | $7,840.00 | $12,698.00 | $48,142.00 |