| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.88 | $492.08 | $492.08 | |
Aetna
| Professional | $83.88 | $83.88 | $83.88 | |
CareFirst
| Professional | $114.40 | $114.40 | $140.10 | |
Cigna
| Professional | $102.59 | $102.59 | $102.59 | |
Kaiser Permanente
| Professional | $133.21 | $133.21 | $406.82 | |
United
| Professional | $68.16 | $102.25 | $159.15 |