| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $517.05 | $517.05 | $517.05 | |
Aetna
| Professional | $517.05 | $517.05 | $758.76 | |
CareFirst
| Professional | $705.27 | $705.27 | $705.27 | |
Cigna
| Professional | $661.77 | $661.77 | $661.77 | |
Kaiser Permanente
| Professional | $821.16 | $821.16 | $2,507.78 | |
United
| Professional | $420.18 | $630.26 | $946.97 |