| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $128.28 | $128.28 | $133.33 | |
Kaiser Permanente
| Professional | $552.84 | $552.84 | $552.84 | |
Medcost
| Facility | $80.20 | $133.65 | $248.38 | |
Medcost
| Professional | $179.00 | $204.00 | $231.00 |