| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.41 | $121.96 | $310.61 | |
Aetna
| Professional | $310.61 | $310.61 | $310.61 | |
CareFirst
| Professional | $205.06 | $205.06 | $205.06 | |
Cigna
| Facility | $310.61 | $310.61 | $310.61 | |
Kaiser Permanente
| Professional | $632.33 | $632.33 | $632.33 | |
United
| Professional | $271.45 | $298.30 | $483.48 |