| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.34 | $83.34 | $83.34 | |
Aetna
| Professional | $83.34 | $83.34 | $83.34 | |
CareFirst
| Professional | $109.00 | $109.00 | $139.19 | |
Cigna
| Professional | $90.75 | $90.75 | $90.75 | |
Kaiser Permanente
| Professional | $132.35 | $132.35 | $404.20 | |
United
| Professional | $67.72 | $101.59 | $152.63 |