| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $263.03 | $263.03 | $2,137.96 | |
Aetna
| Professional | $245.47 | $263.03 | $281.84 | |
Kaiser Permanente
| Professional | $616.60 | $616.60 | $707.95 | |
United
| Professional | $147.91 | $158.49 | $436.52 |