| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.00 | $275.00 | $350.00 | |
Aetna
| Professional | AA | $726.69 | $726.69 | $726.69 |
Aetna
| Professional | QZ | $555.22 | $555.22 | $555.22 |
Denver HMP
| Facility | $55.50 | $2,775.00 | $4,810.00 | |
Kaiser Permanente
| Professional | $260.00 | $375.00 | $621.60 |