| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.12 | $206.12 | $206.12 | |
Aetna
| Professional | $206.12 | $206.12 | $206.12 | |
CareFirst
| Professional | $207.00 | $207.00 | $264.36 | |
Cigna
| Professional | $213.51 | $213.51 | $213.51 | |
Kaiser Permanente
| Professional | $251.36 | $251.36 | $767.65 | |
United
| Professional | $128.62 | $192.93 | $273.32 |