| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.36 | $132.36 | $132.36 | |
Aetna
| Professional | $22.48 | $132.36 | $132.36 | |
CareFirst
| Professional | $147.07 | $147.07 | $151.47 | |
Cigna
| Professional | $109.96 | $130.16 | $403.63 | |
Kaiser Permanente
| Professional | $129.44 | $307.27 | $307.27 | |
United
| Professional | $97.54 | $136.82 | $372.87 |