| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.28 | $63.28 | $69.29 | |
Aetna
| Professional | $63.28 | $69.29 | $72.38 | |
Anthem BCBS
| Professional | $43.50 | $48.49 | $53.88 | |
CareSource
| Facility | $120.00 | $120.00 | $260.00 | |
Cigna
| Professional | $651.35 | $651.35 | $651.35 | |
Kaiser Permanente
| Professional | $123.70 | $127.41 | $137.00 |