| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.28 | $30.47 | $1,260.00 | |
HMSA
| Professional | $11.92 | $50.52 | $50.52 | |
Kaiser Permanente
| Professional | $70.73 | $70.73 | $70.73 | |
United
| Professional | $39.04 | $55.57 | $63.02 |