| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.73 | $68.73 | $68.73 | |
Aetna
| Professional | $68.73 | $68.73 | $68.73 | |
CareFirst
| Professional | $90.00 | $90.00 | $114.82 | |
Cigna
| Professional | $96.83 | $96.83 | $96.83 | |
Kaiser Permanente
| Professional | $109.18 | $109.18 | $333.42 | |
United
| Professional | $55.86 | $83.79 | $125.89 |