| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.73 | $77.73 | $77.73 | |
Aetna
| Professional | $77.73 | $77.73 | $77.73 | |
CareFirst
| Professional | $106.03 | $106.03 | $129.84 | |
Cigna
| Professional | $94.64 | $94.64 | $94.64 | |
Kaiser Permanente
| Professional | $123.45 | $123.45 | $377.03 | |
United
| Professional | $63.17 | $94.75 | $199.31 |