| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.21 | $3.04 | $3.04 | |
Aetna
| Professional | $1.21 | $1.42 | $3.04 | |
Anthem BCBS
| Professional | $39.36 | $39.36 | $65.48 | |
Kaiser Permanente
| Professional | $40.00 | $40.00 | $40.00 | |
Medcost
| Facility | $1.21 | $3.04 | $4.63 |