| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.18 | $117.18 | $117.18 | |
Aetna
| Professional | $117.18 | $117.18 | $117.18 | |
CareFirst
| Professional | $154.00 | $154.00 | $195.73 | |
Cigna
| Professional | $121.35 | $121.35 | $121.35 | |
Kaiser Permanente
| Professional | $186.11 | $186.11 | $568.36 | |
United
| Professional | $95.22 | $142.84 | $222.34 |