| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.00 | $4.00 | $4.00 | |
Aetna
| Professional | $4.00 | $4.00 | $4.00 | |
Ambetter
| Professional | $1.80 | $1.80 | $1.80 | |
Anthem BCBS
| Professional | $1.00 | $1.00 | $1.53 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $1.33 | $1.33 | $1.33 | |
Kaiser Permanente
| Professional | $104.00 | $116.00 | $116.00 |