| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.15 | $92.15 | $92.15 | |
Aetna
| Professional | $79.02 | $92.00 | $92.15 | |
Anthem BCBS
| Professional | $13.08 | $15.77 | $15.77 | |
CareSource
| Facility | $47.17 | $50.54 | $72.41 | |
Cigna
| Professional | $46.50 | $46.50 | $58.13 | |
Kaiser Permanente
| Professional | $166.00 | $166.00 | $257.00 |