| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.58 | $52.58 | $52.58 | |
Aetna
| Professional | $52.58 | $52.58 | $52.58 | |
CareFirst
| Professional | $69.00 | $69.00 | $87.82 | |
Cigna
| Professional | $48.45 | $48.45 | $48.45 | |
Kaiser Permanente
| Professional | $83.51 | $83.51 | $255.02 | |
United
| Professional | $42.73 | $64.09 | $134.81 |