| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
Aetna
| Professional | $19.95 | $25.12 | $33.88 | |
Anthem BCBS
| Professional | $27.54 | $37.15 | $70.79 | |
Kaiser Permanente
| Professional | $26.30 | $26.30 | $77.62 | |
United
| Professional | $28.18 | $52.48 | $100.00 |