| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.65 | $2,080.00 | $6,456.00 | |
Aetna
| Facility | 54 | $282.24 | $282.24 | $441.49 |
Kaiser Permanente
| Professional | $505.79 | $1,140.22 | $1,140.22 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |