| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $186.93 | $186.93 | $186.93 | |
Aetna
| Professional | $186.93 | $186.93 | $186.93 | |
CareFirst
| Professional | $175.94 | $175.94 | $175.94 | |
Cigna
| Facility | $186.93 | $186.93 | $186.93 | |
Kaiser Permanente
| Professional | $27.77 | $27.77 | $27.77 | |
United
| Professional | $166.77 | $183.26 | $297.02 |