| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.01 | $7,579.87 | $20,023.41 | |
Aetna
| Professional | $69.37 | $69.37 | $83.24 | |
CareFirst
| Professional | $69.37 | $77.48 | $88.96 | |
Cigna
| Facility | $63.71 | $63.71 | $69.37 | |
Cigna
| Professional | $69.37 | $69.37 | $86.00 | |
Kaiser Permanente
| Professional | $58.96 | $69.37 | $78.53 | |
United
| Professional | $69.37 | $77.22 | $82.55 |