| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $217.74 | $217.74 | $217.74 | |
Aetna
| Professional | $217.74 | $217.74 | $217.74 | |
CareFirst
| Professional | $219.00 | $219.00 | $279.26 | |
Cigna
| Professional | $170.08 | $170.08 | $170.08 | |
Kaiser Permanente
| Professional | $265.52 | $265.52 | $810.93 | |
United
| Professional | $135.87 | $203.80 | $348.34 |