| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.41 | $120.62 | $120.62 | |
Aetna
| Professional | $94.08 | $107.41 | $120.62 | |
Cigna
| Facility | $138.66 | $138.66 | $138.66 | |
Cigna
| Professional | $104.45 | $104.45 | $104.45 | |
Kaiser Permanente
| Professional | $106.68 | $133.26 | $181.85 | |
Medcost
| Facility | $98.46 | $121.47 | $199.24 | |
Medcost
| Professional | $152.49 | $185.76 | $273.67 | |
Sentara
| Facility | $112.29 | $130.54 | $259.24 | |
Sentara
| Professional | $112.29 | $130.54 | $275.17 | |
United
| Professional | $92.50 | $135.88 | $224.57 |