| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.59 | $16.59 | $16.59 | |
Aetna
| Professional | $16.59 | $16.59 | $18.91 | |
Kaiser Permanente
| Professional | $28.00 | $28.00 | $28.00 | |
United
| Professional | $32.38 | $34.08 | $37.51 |