| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.11 | $18.11 | $18.11 | |
Anthem BCBS
| Facility | $183.20 | $407.10 | $529.23 | |
Anthem BCBS
| Professional | $152.66 | $203.55 | $203.55 | |
Cigna
| Professional | $0.02 | $0.02 | $0.02 | |
Kaiser Permanente
| Professional | $30.28 | $30.28 | $31.19 |