| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.01 | $49.01 | $49.01 | |
Aetna
| Professional | $38.22 | $49.01 | $49.01 | |
Kaiser Permanente
| Professional | $42.11 | $49.84 | $93.32 | |
United
| Professional | $30.52 | $54.60 | $139.34 |