| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.00 | $153.00 | $153.00 | |
Aetna
| Professional | $153.00 | $153.00 | $153.00 | |
Anthem BCBS
| Professional | $237.98 | $357.76 | $872.14 | |
Kaiser Permanente
| Professional | $329.00 | $329.00 | $329.00 |