| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.49 | $104.49 | $104.49 | |
Aetna
| Professional | $104.49 | $104.49 | $104.49 | |
CareFirst
| Professional | $184.00 | $184.00 | $184.00 | |
Cigna
| Professional | $156.91 | $156.91 | $156.91 | |
Kaiser Permanente
| Professional | $144.18 | $144.18 | $437.74 | |
United
| Professional | $113.90 | $170.84 | $231.41 |