| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $503.29 | $503.29 | $819.19 | |
Anthem BCBS
| Professional | $2,500.00 | $2,500.00 | $2,500.00 | |
Cigna
| Facility | $390.00 | $390.00 | $397.80 | |
Cigna
| Professional | $331.50 | $390.00 | $397.80 | |
Kaiser Permanente
| Professional | $5,905.00 | $5,905.00 | $5,905.00 |