| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $819.96 | $1,614.00 | $7,727.00 | |
Aetna
| Facility | 52 | $409.98 | $409.98 | $409.98 |
Kaiser Permanente
| Professional | $783.85 | $1,714.64 | $1,714.64 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |