| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.17 | $212.17 | $212.17 | |
Aetna
| Professional | $212.17 | $212.17 | $212.17 | |
CareFirst
| Professional | $213.00 | $213.00 | $213.00 | |
Cigna
| Professional | $223.50 | $223.50 | $223.50 | |
Kaiser Permanente
| Professional | $258.73 | $258.73 | $790.17 | |
United
| Professional | $132.38 | $198.59 | $281.33 |