| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $75.00 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Anthem BCBS
| Professional | $177.65 | $187.00 | $187.00 | |
Cigna
| Facility | $70.00 | $70.00 | $134.61 | |
Cigna
| Professional | $98.27 | $98.27 | $98.27 | |
Kaiser Permanente
| Professional | $469.00 | $500.00 | $500.00 |