| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.20 | $22.91 | $28.18 | |
Kaiser Permanente
| Professional | $676.08 | $676.08 | $676.08 | |
United
| Facility | $2,454.71 | $2,454.71 | $2,454.71 | |
United
| Professional | $22.39 | $31.62 | $44.67 |