| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.89 | $86.89 | $86.89 | |
Aetna
| Professional | $86.89 | $86.89 | $86.89 | |
CareFirst
| Professional | $114.00 | $114.00 | $145.13 | |
Cigna
| Professional | $87.64 | $87.64 | $87.64 | |
Kaiser Permanente
| Professional | $138.00 | $138.00 | $421.44 | |
United
| Professional | $70.62 | $105.92 | $159.15 |