| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.84 | $28.84 | $28.84 | |
Aetna
| Professional | $28.84 | $28.84 | $37.15 | |
Anthem BCBS
| Professional | $346.74 | $346.74 | $346.74 | |
Cigna
| Professional | $870.96 | $870.96 | $870.96 | |
Kaiser Permanente
| Professional | $100.00 | $100.00 | $100.00 |