| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.78 | $40.78 | $40.78 | |
Aetna
| Professional | $40.78 | $40.78 | $40.78 | |
CareFirst
| Professional | $53.00 | $53.00 | $68.11 | |
Cigna
| Professional | $51.84 | $51.84 | $51.84 | |
Kaiser Permanente
| Professional | $64.77 | $64.77 | $197.78 | |
United
| Professional | $33.14 | $49.70 | $104.55 |