| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,083.88 | $2,776.67 | $41,654.74 | |
Aetna
| Facility | 62 | $19,435.71 | $19,435.71 | $19,435.71 |
Kaiser Permanente
| Professional | $1,152.70 | $2,408.65 | $2,408.65 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |