| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.72 | $138.09 | $166.91 | |
Aetna
| Professional | $96.72 | $96.72 | $96.72 | |
Anthem BCBS
| Professional | $100.00 | $143.52 | $143.52 | |
Cigna
| Professional | $58.65 | $58.65 | $58.65 | |
Kaiser Permanente
| Professional | $317.00 | $317.00 | $492.00 |