| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $438.83 | $438.83 | $438.83 | |
Aetna
| Professional | $21.00 | $438.83 | $438.83 | |
Kaiser Permanente
| Professional | $44.30 | $53.02 | $292.97 | |
United
| Professional | $125.58 | $886.77 | $1,432.70 |