| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $51.12 | |
Aetna
| Professional | $51.12 | $51.12 | $51.12 | |
CareFirst
| Professional | $59.46 | $65.20 | $96.38 | |
Cigna
| Professional | $56.40 | $72.25 | $240.51 | |
Kaiser Permanente
| Professional | $120.86 | $120.86 | $120.86 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $57.56 | $108.59 | $122.01 |