| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.66 | $63.66 | $63.66 | |
Aetna
| Professional | $63.66 | $63.66 | $63.66 | |
CareFirst
| Professional | $86.83 | $86.83 | $106.33 | |
Cigna
| Professional | $64.94 | $64.94 | $64.94 | |
Kaiser Permanente
| Professional | $101.11 | $101.11 | $308.77 | |
United
| Professional | $51.73 | $77.59 | $120.79 |