| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $216.25 | $216.25 | $216.25 | |
Aetna
| Professional | $184.66 | $216.25 | $253.36 | |
Anthem BCBS
| Professional | $177.15 | $260.00 | $533.29 | |
Kaiser Permanente
| Professional | $334.82 | $334.82 | $385.04 |