| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.55 | $54.55 | $54.55 | |
Aetna
| Professional | $54.55 | $54.55 | $54.55 | |
CareFirst
| Professional | $71.00 | $71.00 | $91.12 | |
Cigna
| Professional | $55.09 | $55.09 | $55.09 | |
Kaiser Permanente
| Professional | $86.64 | $86.64 | $264.60 | |
United
| Professional | $44.34 | $65.12 | $103.51 |