| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.13 | $290.68 | $10,995.65 | |
Aetna
| Professional | $99.13 | $99.13 | $99.13 | |
CareFirst
| Professional | $100.81 | $202.12 | $388.90 | |
Cigna
| Facility | $93.52 | $93.52 | $99.13 | |
Kaiser Permanente
| Professional | $84.26 | $84.26 | $99.13 | |
United
| Professional | $98.14 | $112.02 | $145.60 |