| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.47 | $64.47 | $64.47 | |
Aetna
| Professional | $64.47 | $64.47 | $85.90 | |
CareFirst
| Professional | $84.00 | $84.00 | $84.00 | |
Cigna
| Professional | $84.23 | $84.23 | $84.23 | |
Kaiser Permanente
| Professional | $102.39 | $102.39 | $312.70 | |
United
| Professional | $52.40 | $73.25 | $118.09 |