| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $192.49 | $192.49 | $192.49 | |
Aetna
| Professional | $192.49 | $192.49 | $192.49 | |
CareFirst
| Professional | $219.70 | $219.70 | $219.70 | |
Cigna
| Professional | $174.73 | $174.73 | $174.73 | |
Kaiser Permanente
| Professional | $234.73 | $234.73 | $716.87 | |
United
| Professional | $120.11 | $180.17 | $255.24 |