| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.52 | $28.52 | $28.52 | |
Aetna
| Professional | $11.68 | $28.52 | $28.52 | |
Anthem BCBS
| Professional | $2.00 | $2.00 | $3.01 | |
Kaiser Permanente
| Professional | $62.00 | $62.00 | $62.00 |