| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.88 | $38.90 | $38.90 | |
Aetna
| Professional | $21.88 | $33.11 | $61.66 | |
Anthem BCBS
| Facility | $45.71 | $45.71 | $45.71 | |
Anthem BCBS
| Professional | $30.20 | $46.77 | $57.54 | |
Cigna
| Professional | $30.90 | $30.90 | $30.90 | |
Kaiser Permanente
| Professional | $85.11 | $85.11 | $85.11 | |
United
| Professional | $22.91 | $25.70 | $38.90 |