| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Cigna
| Facility | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $371.73 | $371.73 | $371.73 | |
Kaiser Permanente
| Professional | $606.41 | $631.69 | $655.34 | |
Medcost
| Facility | $442.80 | $442.80 | $685.35 | |
Sentara
| Facility | $317.82 | $548.04 | $9,929.00 | |
Sentara
| Professional | $317.82 | $553.39 | $9,929.00 | |
United
| Professional | $380.14 | $629.01 | $956.03 |