| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $884.81 | $3,999.00 | $6,085.00 | |
Aetna
| Facility | 50 | $5,653.50 | $6,301.50 | $7,107.00 |
Kaiser Permanente
| Professional | $341.95 | $748.09 | $748.09 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |