| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $7,727.00 | |
Aetna
| Facility | 53 | $442.33 | $442.33 | $442.33 |
Kaiser Permanente
| Professional | $3,955.17 | $3,955.17 | $3,955.17 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |