| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $374.66 | $374.66 | $374.66 | |
Aetna
| Professional | $374.66 | $374.66 | $374.66 | |
CareFirst
| Professional | $391.89 | $391.89 | $391.89 | |
Cigna
| Professional | $384.89 | $384.89 | $384.89 | |
Kaiser Permanente
| Professional | $456.89 | $456.89 | $1,395.31 | |
United
| Professional | $233.78 | $350.67 | $533.44 |