| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $562.34 | $562.34 | $4,570.88 | |
Aetna
| Professional | $524.81 | $562.34 | $602.56 | |
Kaiser Permanente
| Professional | $1,513.56 | $1,513.56 | $1,513.56 | |
United
| Professional | $309.03 | $331.13 | $933.25 |