| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.97 | $57.97 | $57.97 | |
Aetna
| Professional | $57.97 | $57.97 | $57.97 | |
CareFirst
| Professional | $78.52 | $78.52 | $79.62 | |
Cigna
| Professional | $38.08 | $38.08 | $38.08 | |
Kaiser Permanente
| Professional | $76.15 | $76.15 | $231.20 | |
United
| Professional | $69.20 | $103.82 | $128.62 |