| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.83 | $9.55 | $85.60 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $18.70 | $18.70 | $18.70 | |
Kaiser Permanente
| Professional | $76.00 | $104.00 | $238.00 | |
Wellpoint
| Professional | $7.38 | $32.70 | $32.70 |