| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.14 | $858.54 | $3,460.99 | |
Aetna
| Professional | $102.14 | $102.14 | $102.14 | |
CareFirst
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $119.90 | $119.90 | $119.90 | |
Kaiser Permanente
| Professional | $258.00 | $258.00 | $258.00 |