| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $493.82 | $493.82 | $493.82 | |
Aetna
| Professional | $481.24 | $493.82 | $540.97 | |
Kaiser Permanente
| Professional | $502.96 | $648.82 | $754.43 | |
United
| Professional | $369.33 | $482.98 | $801.79 | |
Wellpoint
| Professional | $64.05 | $64.05 | $64.05 |