| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $337.51 | $337.51 | $337.51 | |
Aetna
| Professional | $288.83 | $337.51 | $337.51 | |
Kaiser Permanente
| Professional | $310.43 | $371.62 | $695.18 | |
United
| Professional | $222.47 | $350.66 | $1,088.69 |