| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $253.05 | $253.05 | $253.05 | |
Aetna
| Professional | $253.05 | $253.05 | $253.05 | |
CareFirst
| Professional | $255.00 | $255.00 | $255.00 | |
Cigna
| Professional | $245.16 | $245.16 | $245.16 | |
Kaiser Permanente
| Professional | $308.58 | $308.58 | $942.42 | |
United
| Professional | $157.90 | $236.85 | $360.30 |