| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $501.19 | $4,265.80 | $10,715.19 | |
Aetna
| Facility | 50 | $10,000.00 | $10,000.00 | $10,000.00 |
Anthem BCBS
| Facility | $6,025.60 | $11,481.54 | $23,988.33 | |
Kaiser Permanente
| Professional | $478.63 | $489.78 | $1,819.70 | |
United
| Facility | $8,511.38 | $12,022.64 | $20,417.38 |