| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.42 | $1,614.00 | $7,727.00 | |
Aetna
| Professional | $75.25 | $82.42 | $82.42 | |
Kaiser Permanente
| Professional | $69.12 | $82.52 | $169.81 | |
United
| Professional | $60.66 | $102.97 | $189.01 |