| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $259.16 | $259.16 | $259.16 | |
Aetna
| Professional | $259.16 | $259.16 | $259.16 | |
CareFirst
| Professional | $261.00 | $261.00 | $261.00 | |
Cigna
| Professional | $227.60 | $227.60 | $227.60 | |
Kaiser Permanente
| Professional | $316.04 | $316.04 | $965.17 | |
United
| Professional | $161.71 | $242.57 | $343.64 |