| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.39 | $124.39 | $124.39 | |
Aetna
| Professional | $124.39 | $124.39 | $124.39 | |
CareFirst
| Professional | $163.00 | $163.00 | $207.76 | |
Cigna
| Professional | $138.63 | $138.63 | $138.63 | |
Kaiser Permanente
| Professional | $197.55 | $197.55 | $603.30 | |
United
| Professional | $101.08 | $151.62 | $318.93 |