| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $30.20 | $30.20 | $30.20 | |
Anthem BCBS
| Professional | $9.55 | $10.00 | $10.00 | |
CareSource
| Facility | $36.31 | $36.31 | $36.31 | |
Cigna
| Professional | $19.50 | $19.50 | $19.50 | |
Kaiser Permanente
| Professional | $47.86 | $47.86 | $47.86 |