| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $271.63 | $271.63 | $271.63 | |
Aetna
| Professional | $271.63 | $271.63 | $271.63 | |
CareFirst
| Professional | $284.50 | $284.50 | $284.50 | |
Cigna
| Professional | $200.41 | $200.41 | $200.41 | |
Kaiser Permanente
| Professional | $331.24 | $331.24 | $1,011.59 | |
United
| Professional | $169.49 | $254.24 | $360.17 |