| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.91 | $108.70 | $168.85 | |
Aetna
| Professional | $96.01 | $114.01 | $147.80 | |
Anthem BCBS
| Professional | $110.15 | $144.62 | $256.83 | |
CareSource
| Facility | $207.73 | $207.73 | $386.51 | |
Cigna
| Professional | $108.19 | $143.94 | $193.01 | |
Kaiser Permanente
| Professional | $164.05 | $230.18 | $230.19 | |
United
| Professional | $106.37 | $143.26 | $230.71 |