| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.33 | $123.33 | $123.33 | |
Aetna
| Professional | $94.03 | $118.38 | $123.33 | |
Anthem BCBS
| Professional | $127.06 | $127.06 | $358.38 | |
Kaiser Permanente
| Professional | $111.56 | $145.03 | $211.96 | |
United
| Facility | $353.00 | $1,580.00 | $2,665.00 | |
United
| Professional | $159.21 | $230.85 | $398.56 |