| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.63 | $76.63 | $76.63 | |
Aetna
| Professional | $73.62 | $76.63 | $76.63 | |
CareFirst
| Professional | $62.30 | $62.30 | $67.91 | |
Cigna
| Professional | $64.28 | $64.28 | $64.28 | |
Kaiser Permanente
| Professional | $77.11 | $159.71 | $159.71 | |
United
| Professional | $54.32 | $69.65 | $202.25 |