| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $481.14 | $2,529.42 | $3,175.00 | |
Aetna
| Facility | 50 | $1,731.00 | $1,731.00 | $1,731.00 |
Kaiser Permanente
| Professional | $939.45 | $2,120.19 | $2,120.19 | |
United
| Facility | $665.00 | $762.00 | $6,342.00 |