| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $519.20 | $519.20 | $519.20 | |
Aetna
| Professional | $519.20 | $519.20 | $519.20 | |
CareFirst
| Professional | $680.00 | $680.00 | $867.19 | |
Cigna
| Professional | $520.60 | $520.60 | $520.60 | |
Kaiser Permanente
| Professional | $824.57 | $824.57 | $2,518.19 | |
United
| Professional | $421.92 | $632.88 | $950.90 |