| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $436.52 | $3,715.35 | $10,715.19 | |
Aetna
| Facility | 50 | $14,791.08 | $14,791.08 | $14,791.08 |
Anthem BCBS
| Facility | $3,467.37 | $6,456.54 | $10,964.78 | |
Kaiser Permanente
| Professional | $501.19 | $512.86 | $1,778.28 | |
United
| Facility | $2,630.27 | $5,754.40 | $12,302.69 |