| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.47 | $49.47 | $59.90 | |
Kaiser Permanente
| Professional | $83.07 | $97.73 | $114.02 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $47.45 | $78.47 | $117.34 |