| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.43 | $88.43 | $88.43 | |
Aetna
| Professional | $88.43 | $88.43 | $88.43 | |
CareFirst
| Professional | $83.23 | $83.23 | $83.23 | |
Cigna
| Facility | $88.43 | $88.43 | $88.43 | |
Kaiser Permanente
| Professional | $193.59 | $193.59 | $193.59 | |
United
| Professional | $78.90 | $86.70 | $140.52 |