| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.61 | $194.61 | $194.61 | |
Aetna
| Professional | $194.61 | $194.61 | $194.61 | |
CareFirst
| Professional | $196.00 | $196.00 | $249.58 | |
Cigna
| Professional | $200.49 | $200.49 | $200.49 | |
Kaiser Permanente
| Professional | $237.32 | $237.32 | $724.74 | |
United
| Professional | $121.43 | $182.14 | $258.02 |