| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.73 | $19.73 | $24,128.00 | |
Aetna
| Professional | $19.02 | $19.73 | $20.21 | |
Anthem BCBS
| Professional | $17.12 | $17.12 | $19.82 | |
CareSource
| Facility | $20.21 | $20.81 | $20.81 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $11.05 | $11.05 | $30.20 | |
Kaiser Permanente
| Professional | $20.21 | $20.21 | $24.25 |