| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $172.21 | $172.21 | $172.21 | |
Aetna
| Professional | $172.21 | $172.21 | $172.21 | |
CareFirst
| Professional | $173.00 | $173.00 | $173.00 | |
Cigna
| Professional | $164.75 | $164.75 | $164.75 | |
Kaiser Permanente
| Professional | $210.01 | $210.01 | $641.36 | |
United
| Professional | $107.46 | $161.18 | $228.34 |