| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $101.38 | $101.38 | $101.38 | |
Aetna
| Professional | $99.87 | $101.38 | $111.58 | |
CareFirst
| Professional | $111.22 | $123.58 | $203.91 | |
Cigna
| Professional | $116.91 | $263.06 | $443.13 | |
Kaiser Permanente
| Professional | $107.12 | $237.48 | $237.48 | |
United
| Professional | $87.15 | $222.54 | $307.74 |