| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.13 | $78.13 | $78.13 | |
Aetna
| Professional | $78.13 | $78.13 | $78.13 | |
CareFirst
| Professional | $102.00 | $102.00 | $130.50 | |
Cigna
| Professional | $87.08 | $87.08 | $87.08 | |
Kaiser Permanente
| Professional | $124.09 | $124.09 | $378.96 | |
United
| Professional | $63.49 | $95.24 | $178.29 |