| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.68 | $102.68 | $102.68 | |
Aetna
| Professional | $62.92 | $100.86 | $122.74 | |
Anthem BCBS
| Professional | $22.59 | $30.41 | $111.38 | |
Cigna
| Professional | $83.40 | $83.40 | $137.59 | |
Kaiser Permanente
| Professional | $25.81 | $27.10 | $33.54 | |
United
| Professional | $56.68 | $126.89 | $212.28 |