| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.42 | $87.42 | $1,800.00 | |
Ambetter
| Facility | $93.91 | $290.45 | $554.29 | |
Kaiser Permanente
| Facility | $214.00 | $214.00 | $253.00 | |
Oscar Health
| Facility | $100.09 | $170.00 | $357.31 |