| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $868.88 | $868.88 | $868.88 | |
Aetna
| Professional | $868.88 | $868.88 | $868.88 | |
CareFirst
| Professional | $874.00 | $874.00 | $1,114.33 | |
Cigna
| Professional | $743.58 | $743.58 | $743.58 | |
Kaiser Permanente
| Professional | $1,059.58 | $1,059.58 | $3,235.88 | |
United
| Professional | $542.16 | $813.25 | $1,152.10 |