| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.19 | $4,073.80 | $4,570.88 | |
Aetna
| Facility | 52 | $1,819.70 | $1,819.70 | $2,238.72 |
Kaiser Permanente
| Professional | $104.71 | $109.65 | $239.88 | |
United
| Facility | $1,023.29 | $6,606.93 | $26,302.68 |