| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.72 | $51.72 | $51.72 | |
Aetna
| Professional | $51.72 | $51.72 | $51.72 | |
CareFirst
| Professional | $68.00 | $68.00 | $86.38 | |
Cigna
| Professional | $58.23 | $58.23 | $58.23 | |
Kaiser Permanente
| Professional | $82.13 | $82.13 | $250.84 | |
United
| Professional | $42.02 | $63.04 | $94.71 |