| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.26 | $74.26 | $74.26 | |
Aetna
| Professional | $74.26 | $74.26 | $74.26 | |
CareFirst
| Professional | $97.00 | $97.00 | $124.03 | |
Cigna
| Professional | $85.67 | $85.67 | $85.67 | |
Kaiser Permanente
| Professional | $117.94 | $117.94 | $360.17 | |
United
| Professional | $60.35 | $90.52 | $136.01 |