| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.64 | $202.08 | $272.31 | |
Aetna
| Professional | $66.64 | $66.64 | $66.64 | |
CareFirst
| Professional | $66.64 | $97.73 | $165.25 | |
Cigna
| Facility | $62.87 | $62.87 | $66.64 | |
Kaiser Permanente
| Professional | $56.64 | $56.64 | $66.64 | |
United
| Professional | $65.97 | $66.64 | $86.52 |