| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.51 | $70.51 | $70.51 | |
Aetna
| Professional | $70.51 | $70.51 | $70.51 | |
CareFirst
| Professional | $92.00 | $92.00 | $117.76 | |
Cigna
| Professional | $62.17 | $62.17 | $62.17 | |
Kaiser Permanente
| Professional | $111.98 | $111.98 | $341.96 | |
United
| Professional | $57.30 | $85.94 | $180.77 |