| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.12 | $87.12 | $87.12 | |
Aetna
| Professional | $87.12 | $87.12 | $87.12 | |
CareFirst
| Professional | $114.00 | $114.00 | $145.52 | |
Cigna
| Professional | $81.72 | $81.72 | $81.72 | |
Kaiser Permanente
| Professional | $138.37 | $138.37 | $422.56 | |
United
| Professional | $70.80 | $106.20 | $159.57 |