| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.14 | $53.14 | $53.14 | |
Aetna
| Professional | $53.14 | $53.14 | $53.14 | |
CareFirst
| Professional | $104.35 | $119.95 | $119.95 | |
Cigna
| Professional | $94.02 | $94.02 | $94.02 | |
Kaiser Permanente
| Professional | $69.86 | $69.86 | $212.11 | |
United
| Professional | $63.34 | $95.02 | $122.24 |