| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.78 | $91.78 | $91.78 | |
Aetna
| Professional | $87.93 | $91.78 | $105.25 | |
Anthem BCBS
| Professional | $92.46 | $139.00 | $213.71 | |
Kaiser Permanente
| Professional | $120.53 | $120.53 | $138.61 |