| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.93 | $125.93 | $125.93 | |
Aetna
| Professional | $125.93 | $125.93 | $125.93 | |
CareFirst
| Professional | $165.00 | $165.00 | $210.33 | |
Cigna
| Professional | $159.56 | $159.56 | $159.56 | |
Kaiser Permanente
| Professional | $199.99 | $199.99 | $610.77 | |
United
| Professional | $102.34 | $143.07 | $230.64 |