| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $361.48 | $361.48 | $361.48 | |
Aetna
| Professional | $361.48 | $361.48 | $361.48 | |
CareFirst
| Professional | $474.00 | $474.00 | $603.76 | |
Cigna
| Professional | $382.77 | $382.77 | $382.77 | |
Kaiser Permanente
| Professional | $574.09 | $574.09 | $1,753.22 | |
United
| Professional | $293.75 | $440.62 | $824.87 |