| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $252.10 | $252.10 | $252.10 | |
Anthem BCBS
| Professional | $0.88 | $17.10 | $19.00 | |
Blue Shield
| Professional | $40.00 | $40.00 | $40.00 | |
Kaiser Permanente
| Professional | $100.00 | $146.00 | $393.93 | |
United
| Facility | $123.28 | $123.28 | $123.28 | |
United
| Professional | $27.03 | $27.03 | $27.03 |