| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.16 | $22.16 | $22.16 | |
Aetna
| Professional | $22.16 | $22.16 | $22.16 | |
Anthem BCBS
| Professional | $15.22 | $18.89 | $22.49 | |
Cigna
| Professional | $228.00 | $228.00 | $228.00 | |
Kaiser Permanente
| Professional | $102.00 | $102.00 | $115.00 | |
Medcost
| Facility | $22.16 | $22.16 | $25.04 |