| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.61 | $131.61 | $131.61 | |
Aetna
| Professional | $131.61 | $131.61 | $131.61 | |
CareFirst
| Professional | $172.00 | $172.00 | $219.83 | |
Cigna
| Professional | $143.22 | $143.22 | $143.22 | |
Kaiser Permanente
| Professional | $209.03 | $209.03 | $638.35 | |
United
| Professional | $106.96 | $160.43 | $337.45 |