| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.50 | $85.50 | $85.50 | |
Aetna
| Professional | $85.50 | $85.50 | $85.50 | |
Anthem BCBS
| Professional | $21.78 | $23.50 | $25.63 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Kaiser Permanente
| Professional | $51.00 | $98.34 | $98.34 |