| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.71 | $107.15 | $112.20 | |
CareFirst
| Professional | $102.33 | $112.20 | $165.96 | |
Cigna
| Professional | $104.71 | $114.82 | $588.84 | |
Kaiser Permanente
| Professional | $162.18 | $288.40 | $288.40 | |
United
| Professional | $85.11 | $102.33 | $354.81 |