| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.18 | $28.18 | $28.18 | |
Aetna
| Professional | $10.96 | $28.18 | $28.84 | |
Anthem BCBS
| Professional | $2.00 | $2.00 | $3.55 | |
Kaiser Permanente
| Professional | $56.23 | $56.23 | $56.23 |