| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.15 | $21.15 | $21.15 | |
Aetna
| Professional | $20.38 | $21.15 | $21.66 | |
Anthem BCBS
| Professional | $18.34 | $18.34 | $21.24 | |
CareSource
| Facility | $21.66 | $22.30 | $22.30 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $11.90 | $11.90 | $32.36 | |
Kaiser Permanente
| Professional | $21.66 | $21.66 | $25.99 |