| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.61 | $67.61 | $95.50 | |
Anthem BCBS
| Professional | $3.55 | $4.17 | $4.47 | |
Cigna
| Facility | $30.90 | $30.90 | $30.90 | |
Cigna
| Professional | $26.30 | $30.90 | $870.96 | |
Kaiser Permanente
| Professional | $812.83 | $812.83 | $812.83 |