| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.91 | $78.91 | $78.91 | |
Aetna
| Professional | $78.91 | $78.91 | $115.79 | |
CareFirst
| Professional | $103.00 | $103.00 | $131.80 | |
Cigna
| Professional | $100.98 | $100.98 | $100.98 | |
Kaiser Permanente
| Professional | $125.32 | $125.32 | $382.72 | |
United
| Professional | $64.12 | $96.19 | $202.32 |