| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $141.25 | |
Aetna
| Professional | $128.82 | $151.36 | $194.98 | |
Anthem BCBS
| Professional | $70.79 | $162.18 | $269.15 | |
Kaiser Permanente
| Professional | $186.21 | $186.21 | $758.58 |