| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $724.77 | $724.77 | $724.77 | |
Aetna
| Professional | $724.77 | $724.77 | $927.71 | |
CareFirst
| Professional | $682.14 | $682.14 | $682.14 | |
Cigna
| Professional | $724.77 | $724.77 | $724.77 | |
Kaiser Permanente
| Professional | $530.85 | $530.85 | $530.85 | |
United
| Professional | $710.56 | $710.56 | $753.19 | |
Wellpoint
| Professional | $205.25 | $205.25 | $205.25 |