| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.19 | $77.19 | $77.19 | |
Aetna
| Professional | $77.19 | $77.19 | $77.19 | |
CareFirst
| Professional | $101.00 | $101.00 | $128.93 | |
Cigna
| Professional | $80.42 | $80.42 | $80.42 | |
Kaiser Permanente
| Professional | $122.60 | $122.60 | $374.40 | |
United
| Professional | $62.73 | $94.10 | $146.46 |