| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $85.74 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Anthem BCBS
| Professional | $20.23 | $23.80 | $23.80 | |
CareSource
| Facility | $25.70 | $25.70 | $36.72 | |
Cigna
| Facility | $32.74 | $32.74 | $32.74 | |
Cigna
| Professional | $23.90 | $23.90 | $32.74 | |
Kaiser Permanente
| Professional | $93.00 | $109.00 | $109.00 |