| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $114.82 | $114.82 | |
Aetna
| Professional | $109.65 | $128.82 | $295.12 | |
Anthem BCBS
| Professional | $109.65 | $147.91 | $218.78 | |
Kaiser Permanente
| Professional | $151.36 | $151.36 | $181.97 |