| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.28 | $82.28 | $82.28 | |
Aetna
| Professional | $82.28 | $82.28 | $82.28 | |
CareFirst
| Professional | $129.49 | $129.49 | $129.49 | |
Cigna
| Professional | $91.70 | $91.70 | $91.70 | |
Kaiser Permanente
| Professional | $130.66 | $130.66 | $399.04 | |
United
| Professional | $66.86 | $100.29 | $150.69 |