| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.40 | $71.40 | $71.40 | |
Aetna
| Professional | $71.40 | $71.40 | $71.40 | |
CareFirst
| Professional | $67.20 | $67.20 | $67.20 | |
Cigna
| Facility | $71.40 | $71.40 | $71.40 | |
Cigna
| Professional | $71.40 | $71.40 | $71.40 | |
Kaiser Permanente
| Professional | $67.76 | $67.83 | $79.80 | |
United
| Professional | $79.80 | $79.80 | $129.34 |