| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.79 | $113.79 | $113.79 | |
Aetna
| Professional | $113.79 | $113.79 | $113.79 | |
CareFirst
| Professional | $223.42 | $256.85 | $256.85 | |
Cigna
| Professional | $203.01 | $203.01 | $203.01 | |
Kaiser Permanente
| Professional | $149.58 | $149.58 | $454.15 | |
United
| Professional | $135.65 | $203.47 | $261.76 |