| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $301.22 | $301.22 | $301.22 | |
Anthem BCBS
| Facility | $4,500.00 | $15,313.10 | $27,168.86 | |
Anthem BCBS
| Professional | $168.18 | $168.18 | $170.19 | |
Kaiser Permanente
| Professional | $1,229.00 | $1,244.00 | $16,272.00 |