| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.22 | $169.22 | $169.22 | |
Aetna
| Professional | $169.22 | $169.22 | $169.22 | |
CareFirst
| Professional | $222.00 | $222.00 | $282.64 | |
Cigna
| Professional | $199.44 | $199.44 | $199.44 | |
Kaiser Permanente
| Professional | $268.75 | $268.75 | $820.74 | |
United
| Professional | $137.52 | $206.27 | $321.07 |