| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.26 | $115.26 | $115.26 | |
Aetna
| Professional | $115.26 | $115.26 | $115.26 | |
CareFirst
| Professional | $151.00 | $151.00 | $151.00 | |
Cigna
| Professional | $135.50 | $135.50 | $135.50 | |
Kaiser Permanente
| Professional | $183.05 | $183.05 | $559.01 | |
United
| Professional | $93.66 | $140.49 | $218.68 |