| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $985.41 | $1,614.00 | $7,727.00 | |
Aetna
| Facility | 52 | $492.71 | $492.71 | $492.71 |
Kaiser Permanente
| Professional | $877.94 | $1,736.83 | $1,925.92 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |