| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $3,323.00 | $6,945.00 | |
Aetna
| Facility | 50 | $9,820.50 | $9,820.50 | $10,114.50 |
Kaiser Permanente
| Professional | $472.47 | $547.07 | $1,037.96 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |