| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.81 | $87.10 | $169.82 | |
Aetna
| Professional | $38.90 | $39.81 | $48.98 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.04 | |
Anthem BCBS
| Professional | $42.66 | $42.66 | $42.66 | |
Kaiser Permanente
| Professional | $40.74 | $40.74 | $40.74 | |
United
| Professional | $42.66 | $42.66 | $42.66 |