| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.20 | $371.54 | $371.54 | |
Aetna
| Professional | $91.20 | $91.20 | $93.33 | |
Anthem BCBS
| Professional | $204.17 | $239.88 | $239.88 | |
Kaiser Permanente
| Professional | $741.31 | $741.31 | $741.31 |