| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.15 | $72.15 | $72.15 | |
Aetna
| Professional | $72.15 | $72.15 | $72.15 | |
CareFirst
| Professional | $95.00 | $95.00 | $120.50 | |
Cigna
| Professional | $80.41 | $80.41 | $80.41 | |
Kaiser Permanente
| Professional | $114.58 | $114.58 | $349.91 | |
United
| Professional | $58.62 | $87.94 | $164.63 |