| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $681.71 | $5,857.00 | $6,547.00 | |
Aetna
| Facility | 52 | $152.49 | $152.49 | $152.49 |
Kaiser Permanente
| Professional | $271.76 | $286.06 | $595.16 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |