| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $723.00 | $742.70 | $1,144.00 | |
Anthem BCBS
| Facility | $988.00 | $1,264.00 | $2,334.00 | |
Kaiser Permanente
| Facility | $118.50 | $224.00 | $1,015.00 | |
Lucent Health
| Facility | $1,063.00 | $1,063.00 | $1,063.00 |