| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.25 | $144.54 | $194.98 | |
Kaiser Permanente
| Professional | $104.71 | $117.49 | $154.88 | |
United
| Facility | $128.82 | $151.36 | $151.36 | |
United
| Professional | $275.42 | $363.08 | $630.96 |