| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.24 | $21.24 | $21.24 | |
Aetna
| Professional | $21.24 | $21.24 | $21.24 | |
Anthem BCBS
| Professional | $15.22 | $18.89 | $22.49 | |
Cigna
| Professional | $228.00 | $228.00 | $228.00 | |
Kaiser Permanente
| Professional | $98.00 | $98.00 | $110.00 | |
Medcost
| Facility | $21.24 | $21.24 | $24.00 |