| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.81 | $39.81 | $39.81 | |
Aetna
| Professional | $39.81 | $39.81 | $39.81 | |
Anthem BCBS
| Professional | $218.78 | $218.78 | $218.78 | |
Cigna
| Professional | $141.25 | $141.25 | $141.25 | |
Kaiser Permanente
| Professional | $100.00 | $537.03 | $537.03 | |
United
| Professional | $34.67 | $39.81 | $60.26 |