| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $179.69 | $179.69 | $179.69 | |
Aetna
| Professional | $78.04 | $179.69 | $179.69 | |
CareFirst
| Professional | $188.23 | $188.23 | $188.23 | |
Cigna
| Professional | $135.78 | $135.78 | $135.78 | |
Kaiser Permanente
| Professional | $252.61 | $527.83 | $527.83 | |
United
| Professional | $88.44 | $132.65 | $232.99 |