| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.98 | $75.98 | $75.98 | |
Aetna
| Professional | $75.98 | $75.98 | $97.27 | |
CareFirst
| Professional | $75.98 | $75.98 | $75.98 | |
Cigna
| Professional | $75.98 | $75.98 | $75.98 | |
Kaiser Permanente
| Professional | $77.00 | $77.00 | $77.00 | |
United
| Professional | $74.50 | $74.50 | $89.40 |