| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.88 | $137.88 | $137.88 | |
Aetna
| Professional | $137.88 | $137.88 | $137.88 | |
CareFirst
| Professional | $139.00 | $139.00 | $176.83 | |
Cigna
| Professional | $117.99 | $117.99 | $117.99 | |
Kaiser Permanente
| Professional | $168.14 | $168.14 | $513.48 | |
United
| Professional | $86.03 | $129.05 | $182.82 |