| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.43 | $41.43 | $41.43 | |
Aetna
| Professional | $41.43 | $41.43 | $41.43 | |
CareFirst
| Professional | $54.00 | $54.00 | $54.00 | |
Cigna
| Professional | $47.17 | $47.17 | $47.17 | |
Kaiser Permanente
| Professional | $65.79 | $65.79 | $200.91 | |
United
| Professional | $33.65 | $50.50 | $75.87 |