| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $972.19 | $2,986.00 | $6,456.00 | |
Aetna
| Facility | 50 | $1,999.50 | $4,512.00 | $4,738.00 |
Kaiser Permanente
| Professional | $385.19 | $845.70 | $845.70 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |