| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.20 | $31.20 | $31.20 | |
Aetna
| Professional | $1.00 | $1.00 | $12.50 | |
Anthem BCBS
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Professional | $50.00 | $65.03 | $105.33 | |
Kaiser Permanente
| Professional | $90.00 | $98.34 | $98.34 |