| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $136.16 | $136.16 | $136.16 | |
Aetna
| Professional | $136.16 | $136.16 | $136.16 | |
CareFirst
| Professional | $291.31 | $291.31 | $291.31 | |
Cigna
| Professional | $166.41 | $166.41 | $166.41 | |
Kaiser Permanente
| Professional | $216.24 | $216.24 | $660.38 | |
United
| Professional | $110.65 | $165.97 | $249.37 |