| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $6,011.00 | $6,945.00 | |
Aetna
| Facility | 52 | $448.33 | $448.33 | $448.33 |
Kaiser Permanente
| Professional | $797.80 | $1,576.15 | $1,743.79 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |