| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.50 | $125.50 | $307.48 | |
Aetna
| Professional | $125.50 | $125.50 | $138.05 | |
Anthem BCBS
| Professional | $135.00 | $135.00 | $135.00 | |
Cigna
| Facility | $137.94 | $137.94 | $137.94 | |
Cigna
| Professional | $87.16 | $137.94 | $137.94 | |
Kaiser Permanente
| Professional | $118.91 | $121.06 | $123.87 | |
Medcost
| Facility | $110.86 | $147.65 | $191.14 | |
Medcost
| Professional | $126.00 | $157.00 | $157.00 | |
United
| Professional | $147.65 | $147.65 | $188.53 |