| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.22 | $59.22 | $59.22 | |
Aetna
| Professional | $59.22 | $59.22 | $59.22 | |
CareFirst
| Professional | $111.36 | $111.36 | $111.36 | |
Cigna
| Professional | $97.62 | $97.62 | $97.62 | |
Kaiser Permanente
| Professional | $80.58 | $80.58 | $244.66 | |
United
| Professional | $66.34 | $99.52 | $129.33 |