| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.52 | $102.52 | $102.52 | |
Aetna
| Professional | $96.84 | $102.52 | $102.52 | |
CareFirst
| Professional | $86.83 | $92.10 | $115.12 | |
Cigna
| Professional | $104.26 | $202.43 | $435.94 | |
Kaiser Permanente
| Professional | $112.08 | $133.68 | $236.26 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 | |
United
| Professional | $66.30 | $128.66 | $245.67 |