| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.29 | $97.29 | $97.29 | |
Aetna
| Professional | $82.04 | $97.29 | $97.29 | |
Kaiser Permanente
| Professional | $101.92 | $120.51 | $214.88 | |
United
| Professional | $71.37 | $123.66 | $276.77 |