| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.80 | $81.70 | $46,967.70 | |
Aetna
| Professional | $78.80 | $81.70 | $117.00 | |
Anthem BCBS
| Facility | $78.80 | $128.29 | $289.20 | |
Anthem BCBS
| Professional | $63.04 | $129.74 | $129.74 | |
CareSource
| Facility | $78.80 | $78.80 | $154.44 | |
Cigna
| Facility | $74.33 | $74.33 | $78.79 | |
Cigna
| Professional | $78.79 | $78.79 | $78.79 | |
Kaiser Permanente
| Professional | $55.18 | $55.18 | $89.57 | |
United
| Professional | $78.80 | $78.80 | $104.89 |