| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.00 | $35.00 | $35.00 | |
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
Anthem BCBS
| Professional | $12.52 | $12.52 | $20.53 | |
Kaiser Permanente
| Professional | $29.00 | $29.00 | $29.00 |