| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $169.82 | |
Aetna
| Professional | $162.18 | $162.18 | $194.98 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.04 | |
Anthem BCBS
| Professional | $190.55 | $190.55 | $190.55 | |
Kaiser Permanente
| Professional | $302.00 | $302.00 | $302.00 | |
United
| Professional | $165.96 | $190.55 | $199.53 |