| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $354.08 | $354.08 | $354.08 | |
Aetna
| Professional | $354.08 | $354.08 | $354.08 | |
CareFirst
| Professional | $367.96 | $367.96 | $367.96 | |
Cigna
| Facility | $367.96 | $367.96 | $367.96 | |
Kaiser Permanente
| Professional | $379.24 | $379.24 | $379.24 | |
United
| Professional | $325.36 | $357.54 | $579.49 |