| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $296.75 | $296.75 | $296.75 | |
Aetna
| Professional | $89.23 | $296.75 | $543.60 | |
Anthem BCBS
| Professional | $94.57 | $146.86 | $717.14 | |
Kaiser Permanente
| Professional | $622.60 | $622.60 | $715.99 |