| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $331.90 | $331.90 | $331.90 | |
Aetna
| Professional | $331.90 | $331.90 | $486.62 | |
CareFirst
| Professional | $435.00 | $435.00 | $435.00 | |
Cigna
| Professional | $372.30 | $372.30 | $372.30 | |
Kaiser Permanente
| Professional | $527.11 | $527.11 | $1,609.76 | |
United
| Professional | $269.70 | $404.56 | $607.85 |