| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $131.83 | |
Aetna
| Professional | $125.89 | $125.89 | $147.91 | |
Anthem BCBS
| Professional | $134.90 | $134.90 | $229.09 | |
Cigna
| Professional | $87.10 | $87.10 | $87.10 | |
Kaiser Permanente
| Professional | $87.10 | $125.89 | $131.83 | |
Medcost
| Professional | $87.10 | $87.10 | $87.10 | |
Medcost
| Facility | $109.65 | $147.91 | $190.55 | |
United
| Facility | $138.04 | $138.04 | $138.04 | |
United
| Professional | $147.91 | $147.91 | $190.55 |