| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.49 | $215.49 | $215.49 | |
Aetna
| Professional | $215.49 | $215.49 | $215.49 | |
CareFirst
| Professional | $245.95 | $245.95 | $276.37 | |
Cigna
| Professional | $195.60 | $195.60 | $195.60 | |
Kaiser Permanente
| Professional | $262.80 | $262.80 | $802.55 | |
United
| Professional | $134.46 | $201.70 | $344.74 |