| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.53 | $21.53 | $21.53 | |
Aetna
| Professional | $19.64 | $21.53 | $21.53 | |
Kaiser Permanente
| Professional | $43.56 | $44.37 | $51.48 | |
United
| Professional | $18.42 | $24.55 | $57.15 |