| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $336.22 | $336.22 | $336.22 | |
Aetna
| Professional | $336.22 | $336.22 | $336.22 | |
CareFirst
| Professional | $440.00 | $440.00 | $561.57 | |
Cigna
| Professional | $373.28 | $373.28 | $373.28 | |
Kaiser Permanente
| Professional | $533.97 | $533.97 | $1,630.71 | |
United
| Professional | $273.22 | $381.95 | $615.77 |