| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $16.98 | $16.98 | |
Aetna
| Professional | $16.98 | $16.98 | $18.20 | |
Anthem BCBS
| Professional | $15.14 | $15.14 | $16.98 | |
Cigna
| Facility | $18.20 | $18.20 | $85.11 | |
Cigna
| Professional | $18.20 | $18.20 | $18.20 | |
Kaiser Permanente
| Professional | $18.20 | $18.20 | $29.51 |