| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $25.12 | $26.30 | |
Aetna
| Professional | $23.99 | $23.99 | $25.12 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.04 | |
Anthem BCBS
| Professional | $29.51 | $29.51 | $29.51 | |
Kaiser Permanente
| Professional | $117.49 | $117.49 | $117.49 | |
United
| Professional | $29.51 | $29.51 | $35.48 |