| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.47 | $82.47 | $82.47 | |
Aetna
| Professional | $82.47 | $82.47 | $82.47 | |
CareFirst
| Professional | $108.00 | $108.00 | $137.75 | |
Cigna
| Professional | $105.13 | $105.13 | $105.13 | |
Kaiser Permanente
| Professional | $130.97 | $130.97 | $399.99 | |
United
| Professional | $67.02 | $100.52 | $151.04 |