| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.14 | $15.44 | $30.54 | |
Aetna
| Professional | $14.14 | $14.14 | $14.14 | |
Anthem BCBS
| Professional | $1.00 | $1.00 | $1.00 | |
Kaiser Permanente
| Professional | $39.00 | $39.00 | $39.00 | |
Medcost
| Facility | $21.54 | $21.54 | $21.54 |