| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $101.90 | $101.90 | $101.90 | |
Aetna
| Professional | $101.90 | $101.90 | $101.90 | |
CareFirst
| Professional | $134.00 | $134.00 | $170.19 | |
Cigna
| Professional | $104.35 | $104.35 | $104.35 | |
Kaiser Permanente
| Professional | $161.83 | $161.83 | $494.21 | |
United
| Professional | $82.80 | $115.76 | $186.62 |