| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.98 | $45.98 | $45.98 | |
Aetna
| Professional | $40.15 | $45.98 | $45.98 | |
Kaiser Permanente
| Professional | $44.64 | $53.45 | $99.99 | |
United
| Professional | $36.39 | $62.77 | $128.78 |