| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $430.43 | $430.43 | $574.00 | |
Aetna
| Professional | $30.00 | $41.00 | $833.00 | |
Kaiser Permanente
| Professional | $315.00 | $455.00 | $581.00 | |
United
| Professional | $46.00 | $60.00 | $98.00 | |
Wellpoint
| Professional | $120.61 | $120.61 | $175.00 |