| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.49 | $84.49 | $84.49 | |
Aetna
| Professional | $84.49 | $84.49 | $84.49 | |
CareFirst
| Professional | $79.52 | $79.52 | $79.52 | |
Cigna
| Facility | $92.77 | $92.77 | $92.77 | |
Kaiser Permanente
| Professional | $238.01 | $238.01 | $238.01 | |
United
| Professional | $82.00 | $93.60 | $156.63 |