| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $152.69 | $152.69 | $152.69 | |
Aetna
| Professional | $152.69 | $152.69 | $152.69 | |
CareFirst
| Professional | $200.00 | $200.00 | $200.00 | |
Cigna
| Professional | $212.45 | $212.45 | $212.45 | |
Kaiser Permanente
| Professional | $242.49 | $242.49 | $740.55 | |
United
| Professional | $124.08 | $186.11 | $279.64 |