| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.88 | $17.88 | $17.88 | |
Anthem BCBS
| Facility | $49.72 | $53.05 | $60.10 | |
Blue Shield
| Professional | $40.00 | $40.00 | $40.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 |