| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.00 | $10.00 | $75.04 | |
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
Kaiser Permanente
| Professional | $32.18 | $32.18 | $37.86 | |
United
| Professional | $15.46 | $18.17 | $96.81 |