| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $68.00 | $85.49 | $162.44 | |
Aetna
| Professional | 25 | $127.51 | $277.99 | $277.99 |
CareFirst
| Professional | $66.16 | $74.98 | $331.65 | |
Cigna
| Professional | $71.73 | $128.97 | $373.90 | |
Kaiser Permanente
| Professional | $154.32 | $178.68 | $343.02 | |
United
| Professional | $77.59 | $122.64 | $355.02 |