| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.38 | $105.38 | $882.61 | |
Aetna
| Professional | $21.00 | $34.49 | $34.49 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Kaiser Permanente
| Professional | $285.00 | $285.00 | $391.00 | |
Wellpoint
| Professional | $22.73 | $22.73 | $22.73 |