| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.28 | $42.28 | $42.28 | |
Aetna
| Professional | $42.28 | $42.28 | $57.60 | |
CareFirst
| Professional | $54.27 | $54.27 | $70.62 | |
Cigna
| Professional | $43.74 | $43.74 | $43.74 | |
Kaiser Permanente
| Professional | $67.15 | $67.15 | $205.06 | |
United
| Professional | $34.36 | $51.53 | $77.43 |