| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.83 | $131.83 | $131.83 | |
Aetna
| Professional | $112.20 | $128.82 | $186.21 | |
Anthem BCBS
| Professional | $147.91 | $181.97 | $251.19 | |
Kaiser Permanente
| Professional | $144.54 | $144.54 | $165.96 |