| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $449.46 | $449.46 | $449.46 | |
Aetna
| Professional | $449.46 | $449.46 | $449.46 | |
CareFirst
| Professional | $470.75 | $470.75 | $576.44 | |
Cigna
| Professional | $365.84 | $365.84 | $365.84 | |
Kaiser Permanente
| Professional | $548.11 | $548.11 | $1,673.89 | |
United
| Professional | $280.45 | $420.68 | $595.97 |