| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.31 | $70.31 | $70.31 | |
Aetna
| Professional | $63.92 | $70.31 | $70.31 | |
Kaiser Permanente
| Professional | $66.79 | $79.95 | $149.57 | |
United
| Professional | $57.61 | $98.77 | $209.29 |