| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.36 | $120.36 | $120.36 | |
Aetna
| Professional | $120.36 | $120.36 | $156.65 | |
CareFirst
| Professional | $158.00 | $158.00 | $158.00 | |
Cigna
| Professional | $139.27 | $139.27 | $139.27 | |
Kaiser Permanente
| Professional | $191.15 | $191.15 | $583.75 | |
United
| Professional | $97.80 | $146.71 | $220.43 |