| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.90 | $3,162.28 | $7,762.47 | |
Aetna
| Professional | $16.98 | $77.62 | $251.19 | |
Kaiser Permanente
| Professional | $56.23 | $66.07 | $66.07 | |
United
| Facility | $213.80 | $457.09 | $1,548.82 | |
United
| Professional | $30.90 | $39.81 | $79.43 |