| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $211.34 | $211.34 | $211.34 | |
Aetna
| Professional | $163.50 | $206.25 | $225.00 | |
CareFirst
| Professional | $211.34 | $211.34 | $211.34 | |
Cigna
| Professional | $232.20 | $232.20 | $232.20 | |
Kaiser Permanente
| Professional | $223.77 | $223.77 | $223.77 | |
United
| Professional | $207.32 | $248.63 | $248.63 | |
Wellpoint
| Professional | $206.57 | $206.57 | $206.57 |