| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $219.05 | $219.05 | $219.05 | |
Aetna
| Professional | $219.05 | $219.05 | $344.89 | |
CareFirst
| Professional | $301.79 | $301.79 | $365.86 | |
Cigna
| Professional | $274.27 | $274.27 | $274.27 | |
Kaiser Permanente
| Professional | $347.88 | $347.88 | $1,062.41 | |
United
| Professional | $178.01 | $267.01 | $401.19 |