| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.98 | $88.98 | $88.98 | |
Aetna
| Professional | $88.98 | $88.98 | $88.98 | |
CareFirst
| Professional | $132.26 | $132.26 | $132.26 | |
Cigna
| Professional | $85.05 | $85.05 | $85.05 | |
Kaiser Permanente
| Professional | $141.32 | $141.32 | $431.56 | |
United
| Professional | $72.31 | $108.46 | $162.96 |