| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.88 | $33.88 | $33.88 | |
Aetna
| Professional | $12.88 | $33.88 | $72.44 | |
Kaiser Permanente
| Professional | $51.29 | $51.29 | $51.29 | |
United
| Professional | $12.02 | $57.54 | $87.10 |