| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.76 | $56.76 | $56.76 | |
Aetna
| Professional | $56.76 | $56.76 | $56.76 | |
CareFirst
| Professional | $74.00 | $74.00 | $94.82 | |
Cigna
| Professional | $63.26 | $63.26 | $63.26 | |
Kaiser Permanente
| Professional | $90.16 | $90.16 | $275.33 | |
United
| Professional | $46.13 | $69.19 | $103.96 |