| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $172.54 | $184.50 | $184.50 | |
Kaiser Permanente
| Professional | $175.72 | $203.46 | $369.93 | |
United
| Facility | $413.00 | $413.00 | $413.00 | |
United
| Professional | $156.27 | $202.78 | $374.66 |