| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.88 | $131.88 | $131.88 | |
Aetna
| Professional | $126.35 | $131.88 | $160.63 | |
Anthem BCBS
| Professional | $124.69 | $161.00 | $307.56 | |
Kaiser Permanente
| Professional | $184.00 | $184.00 | $211.60 |