| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.88 | $134.88 | $134.88 | |
Aetna
| Professional | $130.00 | $134.88 | $134.88 | |
Anthem BCBS
| Professional | $135.04 | $316.31 | $316.31 | |
Cigna
| Facility | $137.80 | $137.80 | $137.80 | |
Cigna
| Professional | $137.80 | $137.80 | $137.80 | |
Kaiser Permanente
| Professional | $177.57 | $177.57 | $177.57 | |
United
| Professional | $332.96 | $332.96 | $339.62 |