| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $416.78 | $817.07 | $2,550.69 | |
Aetna
| Professional | $416.78 | $416.78 | $416.78 | |
CareFirst
| Professional | $416.78 | $416.78 | $1,671.29 | |
Cigna
| Facility | $704.37 | $1,325.91 | $1,515.33 | |
Cigna
| Professional | $483.75 | $483.75 | $531.64 | |
Kaiser Permanente
| Professional | $479.30 | $847.19 | $847.19 | |
United
| Professional | $175.05 | $250.07 | $662.68 |