| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,080.00 | $7,727.00 | |
Aetna
| Facility | 52 | $1,075.78 | $1,075.78 | $1,075.78 |
Kaiser Permanente
| Professional | $1,903.87 | $3,820.61 | $4,171.99 | |
United
| Facility | $645.00 | $1,769.89 | $16,382.00 |