| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.66 | $253.90 | $352.89 | |
Aetna
| Professional | $91.66 | $91.66 | $93.33 | |
Anthem BCBS
| Professional | $203.28 | $239.16 | $239.16 | |
Kaiser Permanente
| Professional | $671.00 | $718.00 | $718.00 |