| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $1,773.31 | $7,727.00 | |
Aetna
| Facility | 52 | $886.66 | $886.66 | $886.66 |
Kaiser Permanente
| Professional | $1,571.18 | $3,136.24 | $3,443.35 | |
United
| Facility | $3,261.00 | $4,165.00 | $26,408.00 |