| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.91 | $169.91 | $169.91 | |
Aetna
| Professional | $160.10 | $177.75 | $218.79 | |
Anthem BCBS
| Professional | $142.08 | $209.00 | $359.98 | |
Kaiser Permanente
| Professional | $228.92 | $228.92 | $918.70 |