| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $89.13 | $151.36 | $295.12 | |
CareFirst
| Professional | $75.86 | $83.18 | $281.84 | |
Cigna
| Professional | $85.11 | $128.82 | $309.03 | |
Kaiser Permanente
| Professional | $131.83 | $154.88 | $194.98 | |
United
| Facility | $79.43 | $79.43 | $107.15 | |
United
| Professional | $79.43 | $125.89 | $239.88 |