| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.86 | $17.86 | $17.86 | |
Aetna
| Professional | $17.86 | $17.86 | $17.86 | |
Anthem BCBS
| Professional | $16.80 | $18.55 | $19.96 | |
Kaiser Permanente
| Professional | $56.00 | $56.00 | $86.00 | |
United
| Professional | $21.01 | $21.01 | $22.69 |