| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $160.24 | $305.57 | $305.57 | |
CareFirst
| Professional | $325.94 | $325.94 | $371.57 | |
Cigna
| Professional | $130.63 | $130.63 | $144.21 | |
Kaiser Permanente
| Professional | $407.43 | $488.92 | $611.15 | |
United
| Professional | $103.54 | $117.69 | $203.72 | |
Wellpoint
| Professional | $203.72 | $203.72 | $203.72 |