| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.22 | $99.22 | $99.22 | |
Aetna
| Professional | $97.24 | $105.90 | $296.10 | |
Anthem BCBS
| Professional | $97.11 | $151.00 | $225.09 | |
Kaiser Permanente
| Professional | $131.22 | $131.22 | $150.91 |