| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $780.27 | $780.27 | $780.27 | |
Anthem BCBS
| Facility | $842.00 | $870.00 | $916.00 | |
Blue Shield
| Facility | $62.90 | $98.70 | $792.00 | |
HealthNet
| Facility | $4,836.99 | $38,001.68 | $119,875.00 | |
Kaiser Permanente
| Facility | $118.50 | $205.00 | $350.00 |