| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.61 | $578.89 | $780.06 | |
Aetna
| Professional | $204.61 | $204.61 | $204.61 | |
CareFirst
| Professional | $204.61 | $319.97 | $541.04 | |
Cigna
| Facility | $193.03 | $193.03 | $204.61 | |
Kaiser Permanente
| Professional | $133.00 | $173.92 | $204.61 | |
United
| Professional | $186.20 | $204.61 | $204.61 |