| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $478.70 | $478.70 | $478.70 | |
Aetna
| Professional | $478.70 | $478.70 | $642.95 | |
CareFirst
| Professional | $614.49 | $614.49 | $799.53 | |
Cigna
| Professional | $537.78 | $537.78 | $537.78 | |
Kaiser Permanente
| Professional | $760.24 | $760.24 | $2,321.73 | |
United
| Professional | $389.00 | $583.50 | $876.71 |