| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $314.61 | $314.61 | $314.61 | |
Aetna
| Professional | $314.61 | $314.61 | $314.61 | |
CareFirst
| Professional | $412.00 | $412.00 | $525.47 | |
Cigna
| Professional | $328.92 | $328.92 | $328.92 | |
Kaiser Permanente
| Professional | $499.65 | $499.65 | $1,525.89 | |
United
| Professional | $255.66 | $383.49 | $576.19 |