| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $202.43 | $202.43 | $202.43 | |
Aetna
| Professional | $202.43 | $202.43 | $202.43 | |
CareFirst
| Professional | $204.00 | $204.00 | $259.62 | |
Cigna
| Professional | $198.33 | $198.33 | $198.33 | |
Kaiser Permanente
| Professional | $246.86 | $246.86 | $753.89 | |
United
| Professional | $126.31 | $189.47 | $268.41 |