| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.19 | $151.19 | $151.19 | |
Aetna
| Professional | $151.19 | $151.19 | $250.00 | |
CareFirst
| Professional | $194.08 | $194.08 | $194.08 | |
Cigna
| Professional | $154.22 | $154.22 | $154.22 | |
Kaiser Permanente
| Professional | $240.12 | $240.12 | $733.30 | |
United
| Professional | $122.86 | $184.30 | $276.89 |