| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.12 | $156.12 | $156.12 | |
Aetna
| Professional | $149.69 | $156.12 | $156.12 | |
CareFirst
| Professional | $131.44 | $131.44 | $131.44 | |
Cigna
| Professional | $94.26 | $94.26 | $94.26 | |
Kaiser Permanente
| Professional | $219.47 | $458.60 | $458.60 | |
United
| Professional | $76.84 | $115.25 | $202.43 |