| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,937.00 | $1,937.00 | $1,937.00 | |
Anthem BCBS
| Facility | $271.00 | $764.04 | $1,505.00 | |
Kaiser Permanente
| Facility | $164.00 | $164.00 | $331.00 | |
Oscar Health
| Facility | $37.00 | $104.00 | $200.00 |