| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $402.49 | $589.84 | $731.80 |
Ambetter
| Professional | AA | $177.30 | $177.30 | $177.30 |
Kaiser Permanente
| Professional | QK | $98.31 | $98.31 | $131.60 |
Kaiser Permanente
| Professional | QX | $98.31 | $98.31 | $131.60 |