| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.24 | $34.24 | $34.24 | |
Aetna
| Professional | $24.51 | $35.99 | $49.55 | |
Ambetter
| Professional | $27.04 | $40.02 | $40.02 | |
Anthem BCBS
| Facility | $54.08 | $75.70 | $198.47 | |
Anthem BCBS
| Professional | $30.75 | $49.01 | $99.28 | |
CareSource
| Facility | $45.97 | $54.08 | $106.00 | |
CareSource
| Professional | $45.97 | $45.97 | $45.97 | |
Cigna
| Facility | $35.60 | $35.60 | $35.60 | |
Cigna
| Professional | $25.99 | $25.99 | $62.63 | |
Kaiser Permanente
| Professional | $41.10 | $54.08 | $100.00 | |
United
| Professional | $17.98 | $26.98 | $50.09 |