| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.08 | $76.08 | $76.08 | |
Aetna
| Professional | $76.08 | $76.08 | $76.08 | |
CareFirst
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $65.05 | $65.05 | $65.05 | |
Kaiser Permanente
| Professional | $120.82 | $120.82 | $368.98 | |
United
| Professional | $61.82 | $92.73 | $195.05 |