| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $179.74 | $179.74 | $269.95 | |
Aetna
| Professional | $158.01 | $230.60 | $335.00 | |
Aetna
| Professional | 25 | $246.91 | $463.84 | $463.84 |
CareFirst
| Professional | $170.04 | $178.99 | $227.35 | |
Cigna
| Professional | $160.97 | $269.18 | $639.78 | |
Kaiser Permanente
| Professional | $160.58 | $231.23 | $642.50 | |
United
| Professional | $187.04 | $501.89 | $678.23 |