| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $23.99 | $23.99 | |
Aetna
| Professional | $23.99 | $23.99 | $30.90 | |
Kaiser Permanente
| Professional | $45.71 | $45.71 | $45.71 | |
United
| Professional | $28.18 | $29.51 | $38.02 |