| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $299.74 | $299.74 | $299.74 | |
Aetna
| Professional | $299.74 | $299.74 | $300.00 | |
CareFirst
| Professional | $103.64 | $115.16 | $298.58 | |
Cigna
| Professional | $49.95 | $1,267.53 | $1,518.64 | |
Kaiser Permanente
| Professional | $1,608.00 | $1,608.00 | $1,608.00 |