| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $81.28 | $3,162.28 | $7,762.47 | |
Aetna
| Professional | $45.71 | $79.43 | $85.11 | |
Kaiser Permanente
| Professional | $79.43 | $85.11 | $169.82 | |
United
| Facility | $165.96 | $549.54 | $5,888.44 | |
United
| Professional | $69.18 | $104.71 | $213.80 |