| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.02 | $65.02 | $65.02 | |
Aetna
| Professional | $65.02 | $65.02 | $65.02 | |
CareFirst
| Professional | $88.62 | $88.62 | $108.61 | |
Cigna
| Professional | $62.93 | $62.93 | $62.93 | |
Kaiser Permanente
| Professional | $103.27 | $103.27 | $315.37 | |
United
| Professional | $52.84 | $79.27 | $119.10 |