| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,884.07 | $6,996.00 | $31,374.00 | |
Aetna
| Facility | 52 | $421.44 | $421.44 | $421.44 |
Kaiser Permanente
| Professional | $749.17 | $1,467.48 | $1,636.71 | |
United
| Facility | $4,062.00 | $5,185.00 | $19,046.00 |