| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.67 | $136.03 | $243.88 | |
Aetna
| Professional | $104.67 | $104.67 | $104.67 | |
CareFirst
| Professional | $118.43 | $118.43 | $118.43 | |
Cigna
| Facility | $115.07 | $115.07 | $115.07 | |
Kaiser Permanente
| Professional | $153.12 | $153.12 | $153.12 | |
United
| Professional | $101.71 | $123.14 | $147.77 |