| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.18 | $114.18 | $114.18 | |
Aetna
| Professional | $114.18 | $114.18 | $114.18 | |
CareFirst
| Professional | $150.00 | $150.00 | $150.00 | |
Cigna
| Professional | $127.25 | $127.25 | $127.25 | |
Kaiser Permanente
| Professional | $181.33 | $181.33 | $553.77 | |
United
| Professional | $92.78 | $139.18 | $209.11 |