| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.50 | $41.69 | $83.18 | |
Aetna
| Professional | $19.05 | $19.50 | $23.99 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.04 | |
Anthem BCBS
| Professional | $20.42 | $20.42 | $20.42 | |
Kaiser Permanente
| Professional | $85.11 | $85.11 | $85.11 | |
United
| Professional | $19.50 | $19.50 | $19.50 |