| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.28 | $81.28 | $81.28 | |
Anthem BCBS
| Facility | $44.67 | $56.23 | $141.25 | |
Anthem BCBS
| Professional | $46.77 | $69.18 | $117.49 | |
Kaiser Permanente
| Professional | $128.82 | $134.90 | $398.11 | |
Providence
| Facility | $45.71 | $69.18 | $199.53 |