| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $494.10 | $494.10 | $494.10 | |
Aetna
| Professional | $494.10 | $494.10 | $663.79 | |
CareFirst
| Professional | $673.96 | $673.96 | $825.27 | |
Cigna
| Professional | $551.92 | $551.92 | $551.92 | |
Kaiser Permanente
| Professional | $784.71 | $784.71 | $2,396.44 | |
United
| Professional | $401.52 | $602.27 | $904.92 |