| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.97 | $65.97 | $65.97 | |
Aetna
| Professional | $65.97 | $65.97 | $65.97 | |
CareFirst
| Professional | $86.00 | $86.00 | $110.19 | |
Cigna
| Professional | $82.02 | $82.02 | $82.02 | |
Kaiser Permanente
| Professional | $104.78 | $104.78 | $319.99 | |
United
| Professional | $53.61 | $80.42 | $120.83 |