| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $398.54 | $398.54 | $398.54 | |
Aetna
| Professional | $398.54 | $398.54 | $398.54 | |
CareFirst
| Professional | $603.25 | $603.25 | $630.98 | |
Cigna
| Professional | $643.37 | $643.37 | $643.37 | |
Kaiser Permanente
| Professional | $586.45 | $586.45 | $1,423.34 | |
United
| Professional | $283.58 | $474.32 | $785.08 |