| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.43 | $132.43 | $132.43 | |
Aetna
| Professional | $132.43 | $132.43 | $132.43 | |
CareFirst
| Professional | $173.00 | $173.00 | $221.19 | |
Cigna
| Professional | $195.70 | $195.70 | $195.70 | |
Kaiser Permanente
| Professional | $210.32 | $210.32 | $642.29 | |
United
| Professional | $107.62 | $161.41 | $339.54 |