| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.83 | $20.83 | $20.83 | |
Aetna
| Professional | $20.83 | $20.83 | $20.83 | |
Anthem BCBS
| Professional | $12.32 | $14.50 | $14.50 | |
Cigna
| Facility | $57.50 | $65.00 | $80.00 | |
Cigna
| Professional | $987.78 | $987.78 | $987.78 | |
Kaiser Permanente
| Professional | $98.34 | $302.00 | $456.00 |