| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.81 | $1,614.00 | $7,727.00 | |
Aetna
| Facility | 52 | $10.91 | $10.91 | $10.91 |
Kaiser Permanente
| Professional | $19.23 | $38.64 | $41.55 | |
United
| Facility | $808.00 | $1,171.00 | $26,408.00 |