| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $524.81 | $549.54 | |
Aetna
| Professional | $30.20 | $57.54 | $537.03 | |
Kaiser Permanente
| Professional | $208.93 | $354.81 | $380.19 | |
United
| Professional | $45.71 | $67.61 | $100.00 |