| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.74 | $29.74 | $29.74 | |
Aetna
| Professional | $29.74 | $29.74 | $37.17 | |
Anthem BCBS
| Professional | $332.50 | $350.00 | $350.00 | |
Cigna
| Facility | $64.00 | $64.00 | $1,195.85 | |
Cigna
| Professional | $872.98 | $872.98 | $872.98 | |
Kaiser Permanente
| Professional | $98.34 | $98.34 | $100.00 |