| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.18 | $182.18 | $182.18 | |
Aetna
| Professional | $182.18 | $182.18 | $182.18 | |
CareFirst
| Professional | $380.38 | $380.38 | $380.38 | |
Cigna
| Facility | $171.87 | $171.87 | $182.18 | |
Cigna
| Professional | $182.18 | $182.18 | $232.02 | |
Kaiser Permanente
| Professional | $154.85 | $154.85 | $504.87 | |
United
| Professional | $182.18 | $182.18 | $295.27 |