| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $19.95 | $19.95 | |
Aetna
| Professional | $10.00 | $19.95 | $162.18 | |
Kaiser Permanente
| Professional | $27.54 | $27.54 | $27.54 | |
United
| Professional | $7.24 | $35.48 | $47.86 |