| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.09 | $284.50 | $4,100.00 | |
Aetna
| Professional | $58.09 | $105.04 | $192.15 | |
CareFirst
| Professional | $52.11 | $52.11 | $660.00 | |
Cigna
| Professional | $54.56 | $109.31 | $238.88 | |
Kaiser Permanente
| Professional | $119.11 | $266.69 | $266.69 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $103.44 | $134.05 | $308.18 |