| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.97 | $33.27 | $33.27 | |
Aetna
| Professional | $13.08 | $13.97 | $14.40 | |
Cigna
| Professional | $42.87 | $89.33 | $117.60 | |
Kaiser Permanente
| Professional | $19.69 | $21.18 | $21.18 |