| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.81 | $13.81 | $13.81 | |
Aetna
| Professional | $13.31 | $13.81 | $13.81 | |
Anthem BCBS
| Professional | $1.00 | $17.95 | $17.95 | |
Kaiser Permanente
| Professional | $81.00 | $81.00 | $96.00 |