| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.76 | $61.76 | $61.76 | |
Aetna
| Professional | $61.76 | $61.76 | $61.76 | |
CareFirst
| Professional | $81.00 | $81.00 | $103.15 | |
Cigna
| Professional | $71.39 | $71.39 | $71.39 | |
Kaiser Permanente
| Professional | $98.09 | $98.09 | $299.54 | |
United
| Professional | $50.19 | $75.28 | $158.35 |