| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.00 | $140.00 | $783.51 | |
Aetna
| Professional | $140.00 | $140.00 | $140.00 | |
Anthem BCBS
| Professional | $241.75 | $266.75 | $266.75 | |
CareSource
| Facility | $231.87 | $231.87 | $311.30 | |
Cigna
| Facility | $223.29 | $223.29 | $223.29 | |
Cigna
| Professional | $163.00 | $163.00 | $223.29 | |
Kaiser Permanente
| Professional | $666.00 | $777.00 | $777.00 | |
United
| Professional | $113.76 | $170.65 | $284.41 |