| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.17 | $40.17 | $40.17 | |
Aetna
| Professional | $40.17 | $40.17 | $40.17 | |
CareFirst
| Professional | $65.31 | $65.31 | $67.09 | |
Cigna
| Professional | $39.31 | $39.31 | $39.31 | |
Kaiser Permanente
| Professional | $63.80 | $63.80 | $194.85 | |
United
| Professional | $32.65 | $48.97 | $103.01 |