| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.54 | $371.54 | $489.78 | |
Aetna
| Professional | $30.20 | $50.12 | $660.69 | |
Kaiser Permanente
| Professional | $269.15 | $371.54 | $478.63 | |
United
| Professional | $44.67 | $60.26 | $87.10 | |
Wellpoint
| Professional | $102.33 | $102.33 | $151.36 |