| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $977.24 | $3,090.30 | $6,456.54 | |
Aetna
| Facility | 50 | $1,995.26 | $4,168.69 | $5,011.87 |
Kaiser Permanente
| Professional | $331.13 | $346.74 | $851.14 | |
United
| Facility | $3,311.31 | $16,218.10 | $33,884.42 |