| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.60 | $161.60 | $161.60 | |
Aetna
| Professional | $148.62 | $161.60 | $161.60 | |
CareFirst
| Professional | $194.83 | $265.75 | $289.67 | |
Cigna
| Professional | $111.74 | $262.02 | $678.76 | |
Kaiser Permanente
| Professional | $138.91 | $337.37 | $337.37 | |
United
| Professional | $187.67 | $245.79 | $488.83 |