| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.09 | $90.09 | $90.09 | |
Aetna
| Professional | $90.09 | $90.09 | $90.09 | |
CareFirst
| Professional | $14.00 | $14.00 | $14.00 | |
Cigna
| Facility | $14.00 | $14.00 | $14.00 | |
Kaiser Permanente
| Professional | $173.76 | $173.76 | $173.76 | |
United
| Professional | $14.56 | $16.00 | $25.93 |