| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.15 | $107.15 | $870.96 | |
Aetna
| Professional | $100.00 | $107.15 | $114.82 | |
CareFirst
| Professional | $102.33 | $114.82 | $123.03 | |
Cigna
| Facility | $234.42 | $239.88 | $549.54 | |
Kaiser Permanente
| Professional | $162.18 | $162.18 | $288.40 | |
United
| Facility | $169.82 | $169.82 | $169.82 | |
United
| Professional | $60.26 | $64.57 | $177.83 |