| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.49 | $34.49 | $34.49 | |
Aetna
| Professional | $30.03 | $34.49 | $34.49 | |
Anthem BCBS
| Professional | $19.32 | $21.34 | $22.73 | |
Cigna
| Facility | $69.03 | $69.03 | $69.03 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Kaiser Permanente
| Professional | $542.00 | $577.00 | $577.00 |