| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.89 | $67.89 | $67.89 | |
Aetna
| Professional | $67.89 | $67.89 | $67.89 | |
CareFirst
| Professional | $63.90 | $63.90 | $63.90 | |
Cigna
| Facility | $67.89 | $67.89 | $67.89 | |
Kaiser Permanente
| Professional | $185.65 | $185.65 | $185.65 | |
United
| Professional | $65.89 | $66.56 | $78.81 |