| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.50 | $55.50 | $55.50 | |
Aetna
| Professional | $55.50 | $55.50 | $55.50 | |
CareFirst
| Professional | $73.00 | $73.00 | $92.70 | |
Cigna
| Professional | $55.33 | $55.33 | $55.33 | |
Kaiser Permanente
| Professional | $88.15 | $88.15 | $269.19 | |
United
| Professional | $45.10 | $65.93 | $142.30 |