| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $154.94 | $154.94 | $154.94 | |
Aetna
| Professional | $154.94 | $154.94 | $154.94 | |
CareFirst
| Professional | $203.00 | $203.00 | $258.80 | |
Cigna
| Professional | $172.70 | $172.70 | $172.70 | |
Kaiser Permanente
| Professional | $246.08 | $246.08 | $751.53 | |
United
| Professional | $125.92 | $188.88 | $283.79 |