| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.25 | $59.25 | $483.48 | |
Aetna
| Professional | $59.25 | $59.25 | $59.25 | |
CareFirst
| Professional | $63.20 | $71.09 | $71.09 | |
Cigna
| Facility | $128.38 | $133.51 | $286.88 | |
Cigna
| Professional | $83.33 | $83.33 | $91.58 | |
Kaiser Permanente
| Professional | $90.85 | $160.58 | $160.58 | |
United
| Professional | $33.18 | $47.40 | $125.61 |