| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.02 | $138.02 | $138.02 | |
Aetna
| Professional | $138.02 | $138.02 | $138.02 | |
CareFirst
| Professional | $188.25 | $188.25 | $188.25 | |
Cigna
| Professional | $140.82 | $140.82 | $140.82 | |
Kaiser Permanente
| Professional | $219.20 | $219.20 | $669.43 | |
United
| Professional | $112.16 | $168.24 | $252.78 |