| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,770.74 | $2,191.73 | $3,026.57 | |
Anthem BCBS
| Facility | $2,361.69 | $11,224.72 | $39,007.80 | |
CareSource
| Facility | $2,190.32 | $2,625.33 | $3,571.23 | |
Kaiser Permanente
| Professional | $1,370.97 | $1,994.14 | $6,950.14 | |
Kaiser Permanente
| Professional | AS | $49.43 | $49.43 | $49.43 |