| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.65 | $127.65 | $127.65 | |
Aetna
| Professional | $127.65 | $127.65 | $127.65 | |
CareFirst
| Professional | $120.14 | $120.14 | $120.14 | |
Cigna
| Facility | $63.43 | $63.43 | $63.43 | |
Kaiser Permanente
| Professional | $145.19 | $145.19 | $145.19 | |
United
| Professional | $113.89 | $125.15 | $202.84 |