| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $25.00 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Anthem BCBS
| Professional | $32.61 | $39.22 | $44.78 | |
Kaiser Permanente
| Professional | $268.00 | $307.00 | $307.00 | |
Medcost
| Facility | $25.00 | $25.00 | $28.25 |