| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,510.00 | $2,510.00 | $5,346.00 | |
Anthem BCBS
| Facility | $2,039.00 | $2,759.00 | $4,577.00 | |
Kaiser Permanente
| Facility | $4,266.50 | $4,266.50 | $4,740.56 |
Specialty Services-Other Specialty Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,510.00 | $2,510.00 | $5,346.00 | |
Anthem BCBS
| Facility | $2,039.00 | $2,759.00 | $4,577.00 | |
Kaiser Permanente
| Facility | $4,266.50 | $4,266.50 | $4,740.56 |