| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.46 | $58.46 | $58.46 | |
Aetna
| Professional | $58.46 | $58.46 | $58.46 | |
CareFirst
| Professional | $79.73 | $79.73 | $97.64 | |
Cigna
| Professional | $59.64 | $59.64 | $59.64 | |
Kaiser Permanente
| Professional | $92.84 | $92.84 | $283.52 | |
United
| Professional | $47.50 | $71.26 | $107.06 |