| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,043.66 | $7,727.00 | |
Aetna
| Facility | 52 | $1,021.83 | $1,021.83 | $1,021.83 |
Kaiser Permanente
| Professional | $1,807.45 | $3,615.37 | $3,962.81 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |