| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.13 | $14.13 | $14.13 | |
Aetna
| Professional | $10.96 | $14.13 | $15.85 | |
Kaiser Permanente
| Professional | $27.54 | $27.54 | $27.54 | |
United
| Professional | $12.30 | $30.20 | $48.98 |