| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.95 | $82.95 | $82.95 | |
Aetna
| Professional | $65.30 | $82.95 | $82.95 | |
CareFirst
| Professional | $76.03 | $76.03 | $76.03 | |
Cigna
| Professional | $47.79 | $47.79 | $47.79 | |
Kaiser Permanente
| Professional | $110.62 | $225.32 | $225.32 | |
United
| Professional | $39.58 | $59.38 | $104.30 |