| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.74 | $146.74 | $146.74 | |
Aetna
| Professional | $146.74 | $146.74 | $192.67 | |
Anthem BCBS
| Professional | $171.34 | $203.33 | $203.33 | |
Kaiser Permanente
| Professional | $205.80 | $211.98 | $211.98 |