| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.33 | $1,614.00 | $7,727.00 | |
Aetna
| Professional | $50.48 | $55.33 | $55.33 | |
Kaiser Permanente
| Professional | $52.62 | $62.76 | $123.14 | |
United
| Professional | $46.99 | $74.98 | $150.16 |