| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.23 | $190.23 | $190.23 | |
Aetna
| Professional | $190.23 | $190.23 | $190.23 | |
CareFirst
| Professional | $191.00 | $191.00 | $243.96 | |
Cigna
| Professional | $127.58 | $127.58 | $127.58 | |
Kaiser Permanente
| Professional | $231.97 | $231.97 | $708.44 | |
United
| Professional | $118.70 | $178.05 | $304.31 |