| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.64 | $118.64 | $118.64 | |
Aetna
| Professional | $118.64 | $118.64 | $118.64 | |
CareFirst
| Professional | $176.35 | $176.35 | $198.15 | |
Cigna
| Professional | $128.90 | $128.90 | $128.90 | |
Kaiser Permanente
| Professional | $188.41 | $188.41 | $575.40 | |
United
| Professional | $96.41 | $144.61 | $304.18 |