| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.22 | $158.22 | $158.22 | |
Aetna
| Professional | $158.22 | $158.22 | $158.22 | |
CareFirst
| Professional | $207.00 | $207.00 | $264.27 | |
Cigna
| Professional | $157.59 | $157.59 | $157.59 | |
Kaiser Permanente
| Professional | $251.28 | $251.28 | $767.41 | |
United
| Professional | $128.58 | $192.86 | $289.77 |