| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.02 | $2.02 | $2.02 | |
Aetna
| Professional | $2.02 | $2.02 | $2.02 | |
Anthem BCBS
| Professional | $93.10 | $98.00 | $98.00 | |
Cigna
| Facility | $128.59 | $128.59 | $163.02 | |
Cigna
| Professional | $93.87 | $93.87 | $93.87 | |
Kaiser Permanente
| Professional | $289.00 | $308.00 | $308.00 |