| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.96 | $214.96 | $214.96 | |
Aetna
| Professional | $214.96 | $214.96 | $214.96 | |
CareFirst
| Professional | $216.00 | $216.00 | $275.69 | |
Cigna
| Professional | $190.44 | $190.44 | $190.44 | |
Kaiser Permanente
| Professional | $262.14 | $262.14 | $800.56 | |
United
| Professional | $134.13 | $201.20 | $285.02 |