| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $346.06 | |
Aetna
| Professional | $141.25 | $141.25 | $155.37 | |
Anthem BCBS
| Professional | $142.00 | $142.00 | $142.00 | |
Cigna
| Facility | $148.50 | $148.50 | $148.50 | |
Cigna
| Professional | $148.50 | $148.50 | $148.50 | |
Kaiser Permanente
| Professional | $173.00 | $173.00 | $173.00 | |
Medcost
| Facility | $158.96 | $158.96 | $215.12 | |
United
| Professional | $158.96 | $158.96 | $190.75 |