| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.00 | $10.59 | $10.59 | |
Cigna
| Facility | $46.00 | $46.00 | $63.00 | |
Cigna
| Professional | $4.83 | $4.83 | $4.83 | |
Kaiser Permanente
| Professional | $10.00 | $10.00 | $15.00 | |
Wellpoint
| Professional | $5.58 | $9.69 | $9.69 |