| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.42 | $59.42 | $59.42 | |
Aetna
| Professional | $59.42 | $59.42 | $59.42 | |
CareFirst
| Professional | $78.00 | $78.00 | $99.24 | |
Cigna
| Professional | $73.31 | $73.31 | $73.31 | |
Kaiser Permanente
| Professional | $94.36 | $94.36 | $288.18 | |
United
| Professional | $48.28 | $72.43 | $108.82 |