| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.49 | $645.65 | $2,818.38 | |
Aetna
| Professional | $117.49 | $117.49 | $165.96 | |
Anthem BCBS
| Professional | $3.24 | $3.80 | $4.79 | |
Cigna
| Professional | $14.13 | $14.13 | $14.13 | |
Kaiser Permanente
| Professional | $100.00 | $100.00 | $100.00 |