| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.37 | $239.37 | $239.37 | |
Aetna
| Professional | $239.37 | $239.37 | $659.93 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $364.65 | $364.65 | $364.65 | |
Kaiser Permanente
| Professional | $98.34 | $98.34 | $100.00 |