| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.00 | $128.00 | $128.00 | |
Aetna
| Professional | $46.91 | $72.09 | $136.28 | |
CareFirst
| Professional | $31.61 | $31.61 | $232.67 | |
Cigna
| Professional | $49.95 | $93.84 | $165.09 | |
Kaiser Permanente
| Professional | $77.53 | $123.91 | $171.50 | |
United
| Professional | $68.34 | $92.70 | $184.84 |