| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.11 | $207.87 | $246.40 | |
Anthem BCBS
| Facility | $220.06 | $266.06 | $700.71 | |
Contra Costa Health
| Professional | $124.60 | $185.70 | $306.14 | |
Kaiser Permanente
| Professional | $190.59 | $254.12 | $476.97 | |
Lucent Health
| Facility | $454.27 | $934.03 | $1,005.91 | |
Providence
| Facility | $195.50 | $254.12 | $352.35 |