| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Blue Shield
| Professional | $40.00 | $40.00 | $40.00 | |
Kaiser Permanente
| Professional | $638.07 | $638.07 | $801.00 | |
Lucent Health
| Facility | $90.00 | $90.00 | $90.00 |