| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $1,614.00 | $7,727.00 | |
Aetna
| Facility | 52 | $778.25 | $778.25 | $778.25 |
Kaiser Permanente
| Professional | $1,381.49 | $2,741.67 | $3,025.67 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |