| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.92 | $63.92 | $63.92 | |
Aetna
| Professional | $59.29 | $69.97 | $76.12 | |
Kaiser Permanente
| Professional | $66.79 | $80.15 | $100.19 | |
United
| Professional | $56.31 | $73.45 | $138.83 |