| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.11 | $112.09 | $136.16 | |
Aetna
| Professional | $48.11 | $48.11 | $48.11 | |
CareFirst
| Professional | $55.29 | $63.02 | $90.08 | |
Cigna
| Professional | $52.09 | $70.43 | $230.11 | |
Kaiser Permanente
| Professional | $112.39 | $112.39 | $112.39 | |
United
| Facility | $165.00 | $442.00 | $12,340.00 | |
United
| Professional | $53.65 | $79.17 | $129.00 |