| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $313.50 | $313.50 | $313.50 | |
Aetna
| Professional | $313.50 | $313.50 | $313.50 | |
CareFirst
| Professional | $411.00 | $411.00 | $523.63 | |
Cigna
| Professional | $402.09 | $402.09 | $402.09 | |
Kaiser Permanente
| Professional | $497.89 | $497.89 | $1,520.54 | |
United
| Professional | $254.76 | $345.04 | $574.16 |