| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.67 | $126.67 | $126.67 | |
Aetna
| Professional | $126.67 | $126.67 | $185.87 | |
CareFirst
| Professional | $166.00 | $166.00 | $211.55 | |
Cigna
| Professional | $157.99 | $157.99 | $157.99 | |
Kaiser Permanente
| Professional | $201.16 | $201.16 | $614.32 | |
United
| Professional | $102.93 | $154.40 | $289.02 |