| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.23 | $21.24 | $21.24 | |
Cigna
| Professional | $228.00 | $228.00 | $228.00 | |
Kaiser Permanente
| Professional | $86.00 | $98.00 | $98.00 | |
Wellpoint
| Professional | $22.00 | $22.00 | $22.00 |