| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $489.26 | $489.26 | $489.26 | |
Aetna
| Professional | $460.48 | $489.26 | $489.26 | |
CareFirst
| Professional | $508.43 | $508.43 | $508.43 | |
Cigna
| Facility | $489.26 | $489.26 | $528.86 | |
Cigna
| Professional | $508.43 | $508.43 | $599.55 | |
Kaiser Permanente
| Professional | $752.37 | $752.37 | $752.37 | |
United
| Professional | $575.60 | $640.76 | $684.96 |