| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.29 | $46.29 | $46.29 | |
Aetna
| Professional | $46.29 | $46.29 | $46.29 | |
CareFirst
| Professional | $63.12 | $63.12 | $77.31 | |
Cigna
| Professional | $47.20 | $47.20 | $47.20 | |
Kaiser Permanente
| Professional | $73.52 | $73.52 | $224.53 | |
United
| Professional | $37.61 | $56.42 | $84.78 |