| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.19 | $134.19 | $134.19 | |
Aetna
| Professional | $134.19 | $134.19 | $134.19 | |
CareFirst
| Professional | $130.66 | $223.79 | $378.41 | |
Cigna
| Facility | $126.60 | $126.60 | $177.04 | |
Kaiser Permanente
| Professional | $114.06 | $114.06 | $134.19 | |
United
| Professional | $132.85 | $174.66 | $234.02 |