| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.52 | $206.96 | $278.88 | |
Aetna
| Professional | $71.52 | $71.52 | $71.52 | |
CareFirst
| Professional | $71.52 | $117.50 | $198.68 | |
Cigna
| Facility | $67.47 | $67.47 | $71.52 | |
Kaiser Permanente
| Professional | $60.79 | $60.79 | $71.52 | |
United
| Professional | $65.08 | $71.52 | $115.92 |