| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.85 | $15.85 | $15.85 | |
Aetna
| Professional | $15.85 | $16.22 | $37.15 | |
Kaiser Permanente
| Professional | $25.12 | $25.12 | $25.12 | |
United
| Facility | $12.02 | $12.02 | $12.02 | |
United
| Professional | $12.88 | $13.49 | $17.38 |