| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.88 | $141.88 | $141.88 | |
Aetna
| Professional | $141.88 | $141.88 | $195.31 | |
CareFirst
| Professional | $230.62 | $230.62 | $236.98 | |
Cigna
| Professional | $156.34 | $156.34 | $156.34 | |
Kaiser Permanente
| Professional | $225.33 | $225.33 | $688.15 | |
United
| Professional | $115.30 | $172.94 | $259.85 |