| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.23 | $67.61 | $75.86 | |
Kaiser Permanente
| Professional | $89.13 | $95.50 | $112.20 | |
United
| Facility | $2,454.71 | $2,454.71 | $2,454.71 | |
United
| Professional | $70.79 | $81.28 | $100.00 |