| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.41 | $42.41 | $42.41 | |
Aetna
| Professional | $18.19 | $42.41 | $59.32 | |
Anthem BCBS
| Professional | $26.63 | $38.15 | $76.01 | |
Kaiser Permanente
| Professional | $76.39 | $91.67 | $192.50 | |
United
| Professional | $110.00 | $112.00 | $130.00 |