| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.38 | $97.83 | $146.76 | |
Aetna
| Professional | $5.00 | $23.15 | $70.00 | |
Cigna
| Facility | $99.00 | $114.00 | $117.60 | |
Cigna
| Professional | $50.59 | $50.59 | $50.59 | |
Kaiser Permanente
| Professional | $98.00 | $98.00 | $176.00 | |
Wellpoint
| Professional | $22.00 | $22.00 | $22.00 |