| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $376.10 | $376.10 | $376.10 | |
Aetna
| Professional | $376.10 | $376.10 | $791.01 | |
CareFirst
| Professional | $840.46 | $840.46 | $840.46 | |
Cigna
| Professional | $593.37 | $593.37 | $593.37 | |
Kaiser Permanente
| Professional | $512.41 | $512.41 | $1,555.77 | |
United
| Professional | $420.18 | $630.26 | $822.44 |