| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.41 | $62.41 | $62.41 | |
Aetna
| Professional | $62.41 | $62.41 | $62.41 | |
CareFirst
| Professional | $82.88 | $82.88 | $82.88 | |
Cigna
| Facility | $58.88 | $58.88 | $62.41 | |
Cigna
| Professional | $62.41 | $62.41 | $79.48 | |
Kaiser Permanente
| Professional | $53.05 | $53.05 | $83.43 | |
United
| Professional | $62.41 | $62.41 | $101.15 |