| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $672.08 | $3,417.00 | $4,047.00 | |
Aetna
| Facility | 52 | $138.86 | $138.86 | $825.13 |
Kaiser Permanente
| Professional | $1,335.07 | $3,059.92 | $3,059.92 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |