| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $735.00 | $777.00 | |
Aetna
| Professional | $30.00 | $30.00 | $560.00 | |
Kaiser Permanente
| Professional | $492.87 | $492.87 | $532.00 | |
United
| Professional | $46.00 | $71.54 | $111.59 |