| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.00 | $90.00 | $90.00 | |
Aetna
| Professional | $90.00 | $90.00 | $90.00 | |
CareFirst
| Professional | $67.00 | $67.00 | $67.00 | |
Cigna
| Professional | $90.80 | $90.80 | $90.80 | |
Kaiser Permanente
| Professional | $335.00 | $335.00 | $335.00 |