| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $186.70 | $186.70 | $186.70 | |
Aetna
| Professional | $186.70 | $186.70 | $186.70 | |
CareFirst
| Professional | $188.00 | $188.00 | $239.44 | |
Cigna
| Professional | $177.53 | $177.53 | $177.53 | |
Kaiser Permanente
| Professional | $227.67 | $227.67 | $695.29 | |
United
| Professional | $116.50 | $174.74 | $298.66 |