| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $272.64 | $272.64 | $272.64 | |
Aetna
| Professional | $272.64 | $272.64 | $272.64 | |
CareFirst
| Professional | $357.00 | $357.00 | $455.37 | |
Cigna
| Professional | $382.28 | $382.28 | $382.28 | |
Kaiser Permanente
| Professional | $432.99 | $432.99 | $1,322.33 | |
United
| Professional | $221.55 | $332.33 | $699.03 |