| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.61 | $119.61 | $119.61 | |
Aetna
| Professional | $119.61 | $119.61 | $119.61 | |
CareFirst
| Professional | $29.91 | $29.91 | $29.91 | |
Cigna
| Facility | $131.35 | $131.35 | $131.35 | |
Kaiser Permanente
| Professional | $77.75 | $77.75 | $77.75 | |
United
| Professional | $116.11 | $132.53 | $168.89 |