| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.67 | $44.67 | $44.67 | |
Aetna
| Professional | $26.92 | $39.81 | $50.12 | |
Kaiser Permanente
| Professional | $45.71 | $50.12 | $100.00 | |
United
| Professional | $36.31 | $52.48 | $128.82 |