| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $139.57 | $139.57 | $139.57 | |
Aetna
| Professional | $139.57 | $139.57 | $139.57 | |
CareFirst
| Professional | $183.00 | $183.00 | $183.00 | |
Cigna
| Professional | $137.40 | $137.40 | $137.40 | |
Kaiser Permanente
| Professional | $221.65 | $221.65 | $676.91 | |
United
| Professional | $113.41 | $170.12 | $255.60 |