| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.13 | $91.13 | $91.13 | |
Aetna
| Professional | $91.13 | $91.13 | $110.39 | |
CareFirst
| Professional | $119.00 | $119.00 | $119.00 | |
Cigna
| Professional | $92.15 | $92.15 | $92.15 | |
Kaiser Permanente
| Professional | $144.74 | $144.74 | $442.01 | |
United
| Professional | $74.06 | $111.09 | $166.91 |