| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $216.92 | $216.92 | $216.92 | |
Aetna
| Professional | $216.92 | $216.92 | $216.92 | |
CareFirst
| Professional | $216.92 | $216.92 | $216.92 | |
Cigna
| Facility | $238.19 | $238.19 | $238.19 | |
Kaiser Permanente
| Professional | $326.08 | $326.08 | $326.08 | |
United
| Professional | $210.99 | $247.53 | $306.24 |