| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.03 | $309.03 | $407.38 | |
Aetna
| Professional | $30.20 | $50.12 | $549.54 | |
Kaiser Permanente
| Professional | $223.87 | $309.03 | $398.11 | |
United
| Professional | $44.67 | $60.26 | $87.10 | |
Wellpoint
| Professional | $87.10 | $87.10 | $125.89 |