| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.45 | $322.83 | $435.02 | |
Aetna
| Professional | $112.45 | $112.45 | $112.45 | |
CareFirst
| Professional | $112.46 | $189.87 | $321.05 | |
Cigna
| Facility | $106.09 | $106.09 | $112.45 | |
Kaiser Permanente
| Professional | $95.58 | $95.58 | $112.45 | |
United
| Professional | $102.33 | $112.45 | $182.26 |