| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $104.71 | $104.71 | |
Aetna
| Professional | $51.29 | $85.11 | $117.49 | |
Kaiser Permanente
| Professional | $69.18 | $81.28 | $446.68 | |
United
| Facility | $1,258.93 | $1,479.11 | $1,737.80 | |
United
| Professional | $37.15 | $177.83 | $489.78 |