| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.28 | $124.28 | $124.28 | |
Aetna
| Professional | $124.28 | $124.28 | $124.28 | |
CareFirst
| Professional | $250.57 | $280.93 | $280.93 | |
Cigna
| Professional | $227.98 | $227.98 | $227.98 | |
Kaiser Permanente
| Professional | $167.76 | $167.76 | $509.33 | |
United
| Professional | $141.30 | $211.96 | $272.67 |