| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $219.62 | $219.62 | $219.62 | |
Aetna
| Professional | $219.62 | $219.62 | $219.62 | |
CareFirst
| Professional | $288.00 | $288.00 | $366.82 | |
Cigna
| Professional | $253.40 | $253.40 | $253.40 | |
Kaiser Permanente
| Professional | $348.79 | $348.79 | $1,065.20 | |
United
| Professional | $178.47 | $267.70 | $563.10 |