| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.33 | $70.33 | $70.33 | |
Aetna
| Professional | $27.82 | $67.48 | $70.33 | |
Anthem BCBS
| Facility | $46.57 | $86.41 | $102.04 | |
Anthem BCBS
| Professional | $58.12 | $72.66 | $108.56 | |
Kaiser Permanente
| Professional | $37.29 | $37.29 | $52.21 | |
United
| Professional | $34.01 | $77.65 | $130.12 |