| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.00 | $5,578.00 | $6,150.00 | |
Aetna
| Facility | 50 | $8,703.00 | $8,703.00 | $8,703.00 |
Kaiser Permanente
| Professional | $661.84 | $1,296.07 | $1,448.38 | |
United
| Facility | $2,648.00 | $9,894.00 | $26,408.00 |