| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.00 | $116.00 | $158.00 | |
Anthem BCBS
| Facility | $148.00 | $215.00 | $252.00 | |
Cigna
| Facility | $72.00 | $150.00 | $260.00 | |
Kaiser Permanente
| Facility | $16.00 | $16.00 | $16.00 | |
Sentara
| Facility | $85.00 | $85.00 | $85.00 |