| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.45 | $55.45 | $55.45 | |
Aetna
| Professional | $55.45 | $55.45 | $81.37 | |
CareFirst
| Professional | $73.00 | $73.00 | $92.62 | |
Cigna
| Professional | $63.42 | $63.42 | $63.42 | |
Kaiser Permanente
| Professional | $88.07 | $88.07 | $268.95 | |
United
| Professional | $45.06 | $67.59 | $101.55 |