| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.16 | $99.16 | $99.16 | |
Aetna
| Professional | $99.16 | $99.16 | $99.16 | |
CareFirst
| Professional | $81.92 | $81.92 | $100.30 | |
Cigna
| Professional | $74.93 | $74.93 | $74.93 | |
Kaiser Permanente
| Professional | $291.27 | $291.27 | $291.27 | |
United
| Professional | $48.80 | $73.20 | $121.17 |