| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.65 | $120.65 | $120.65 | |
Aetna
| Professional | $120.65 | $120.65 | $120.65 | |
CareFirst
| Professional | $158.00 | $158.00 | $201.51 | |
Cigna
| Professional | $139.19 | $139.19 | $139.19 | |
Kaiser Permanente
| Professional | $191.61 | $191.61 | $585.15 | |
United
| Professional | $98.04 | $147.07 | $220.97 |