| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.00 | $81.00 | $81.00 | |
Anthem BCBS
| Facility | $42.59 | $51.50 | $135.63 | |
Anthem BCBS
| Professional | $45.29 | $65.86 | $108.23 | |
Kaiser Permanente
| Professional | $135.00 | $393.93 | $393.93 | |
Providence
| Facility | $68.84 | $68.84 | $85.86 |