| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $537.03 | $537.03 | $4,365.16 | |
Aetna
| Professional | $501.19 | $537.03 | $575.44 | |
Kaiser Permanente
| Professional | $1,445.44 | $1,445.44 | $1,445.44 | |
United
| Professional | $295.12 | $316.23 | $891.25 |