| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $277.02 | $277.02 | $277.02 | |
Aetna
| Professional | $277.02 | $277.02 | $324.61 | |
CareFirst
| Professional | $260.74 | $260.74 | $260.74 | |
Cigna
| Professional | $277.02 | $277.02 | $277.02 | |
Kaiser Permanente
| Professional | $293.33 | $293.33 | $293.33 | |
United
| Professional | $271.60 | $271.60 | $391.78 |